【作者】 蔡丽伟；

【导师】 丁艳华；

【作者基本信息】 吉林大学 ， 临床医学， 2012， 硕士

【摘要】 研究背景：肾脏是EH的主要靶器官损伤之一，早期损伤主要表现为微量蛋白尿的增加。严重肾脏损害可致肾功能衰竭，故对疾病的早期诊断有利于疾病的防治和延缓病情的进展。研究表明多种因素参与EH肾损害的形成，如环境因素和基因因素等。HLA是目前已知的最复杂的人类基因复合体，近年来HLA与疾病的关联性已成为群体遗传学及免疫相关疾病研究的热点。目的：研究原发性高血压肾损害的相关因素，探讨HLA-DRB1单核苷酸多态性与原发性高血压肾损害的关联，为人群高血压肾损害的防治提供科学依据。方法：筛查纳入185例原发性高血压患者，分为单纯高血压组和高血压肾损害组。详细询问病史及查询病历，并检测腰腹围、体重指数、空腹血糖、总胆固醇、甘油三酯、尿酸、白蛋白等。运用PCR-LDR技术，检测HLA-DRB1rs2308765、rs9269186及rs3135388三个SNPs位点与原发性高血压肾损害的关联。最后应用SAS统计软件对资料进行处理。结果：（1）对所研究的相关因素进行单因素分析，结果发现年龄、空腹血糖、高血压病程、血压控制水平、是否合并糖尿病在两组间的差异具有统计学意义（P＜0.05），其他因素在两组间无相关性。进行非条件Logistic回归分析后，血压控制水平、是否合并糖尿病与肾损害仍相关联（P＜0.05）。（2）rs2308765、rs9269186及rs3135388基因型频率均符合H-W遗传平衡定律，经统计分析发现三个位点在两组间基因型及等位基因频率分布均无统计学意义（P＞0.05）。结论：（1）血压控制水平、合并糖尿病可能是原发性高血压肾损害的危险因素；（2）本研究未发现性别、年龄、腰腹围、体重指数、尿酸、空腹血糖、总胆固醇、甘油三酯、高密度胆固醇脂蛋白、低密度胆固醇脂蛋白等与原发性高血压肾损害有关；（3）HLA-DRB1rs2308765、rs9269186及rs3135388单核甘酸多态性与原发性高血压肾损害无关。更多还原

【Abstract】 Background: The kidney is the main target organ damage in EH, early damage ismainly manifested in the increase in microalbuminuria. Severe kidney damage can lead torenal failure.Therefore, the early diagnosis is benefit for the disease prevention andtreatment,and delay disease progression. The study showed that a variety of factorsinvolved in the formation of the EH kidney damage, such as environmental factors andgenetic factors. HLA is the most complex gene complex. In recent years, the association ofHLA and disease has become the research focus of the population genetics andimmune-related diseases.Objective:To research kidney damage related factors in elderly essentialhypertension,discusses the relationship of HLA-DRB1SNP and primary hypertension renaldamage,and provide a scientific basis for prevention and treatment of hypertension kidneydamage.Methods:Screening185cases with essential hypertension,divided into twogroups,simple hypertension and hypertensive kidney damage.Ask for details of the historyand inquire the medical records,and survey waist circumference,body mass index,fastingglucose,total cholesterol,triglycerides,uric acid,albumin,and so on.Use of PCR-LDRdetection the relationship of HLA-DRB1rs2308765,rs9269186,rs3135388SNPs andessential hypertension kidney damage.Finally,use the SAS statistical software for dataprocessing.Results:(1)Trough the univariate analysis of the relevant factors found that age,fastingblood glucose,the time of hypertension,blood pressure control,and whether diabetesmellitus has statistically significance in the two groups(P<0.05),other factors has nocorrelation between the two groups.Logistic regression analysis,blood pressurecontrol,creatinine, diabetes still has statistically significance in the two groups(P<0.05).(2)rs2308765, rs9269186and rs3135388genotype frequencies are in line with H-W geneticequilibrium, statistical analysis found that three sites in the distribution of genotypes andallele frequencies had no statistically significant between the two groups(P>0.05).Conclusion:(1)Blood pressure control,diabetes mellitus may be risk factors of theelderly essential hypertension kidney damage.(2) This experiment did not found sex,age,waistline,abdomen circumference,body mass index,uric acid,fasting plasmaglucose,total cholesterol, triglyeride, high density lipoproteinmay have relationship withthe elderly essential hypertension kidney damage.(3)HLA-DRB1rs2308765, rs9269186and rs3135388single nucleotide polymorphism may have no relationship with the elderly更多还原