| 朱阿楠,方亚君,许红,王利峰,陈洪宇,俞艳雯.2型糖尿病肾病CX3CR1基因多态性相关因素及中医证型分析[J].浙江中西医结合杂志,2016,26(4): |
| 2型糖尿病肾病CX3CR1基因多态性相关因素及中医证型分析 |
| Analysis on the Correlated Factors of CX3CR1 Mutation and the Different TCM Syndromes inType-2 Diabetic Nephropathy |
| 投稿时间：2015-06-12 修订日期：2015-11-03 |
| DOI： |
| 中文关键词: 糖尿病肾病 中医证候 尿微量白蛋白／肌酐比值 同型半胱氨酸 CX3CR1 炎症介质 |
| 英文关键词:Diabetic nephro pa thy TCM syndrome urinary albumin to creatinine ratio, Homocysteine ( Hcy ) CX3CR1 mediators of inflammation |
| 基金项目:] 浙江省余姚市科技局项目(No. 2009Y11) |
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| 中文摘要: |
| 目的 探讨糖尿病肾病( DN) 患者CX3CR1-V249I基因突变与中医证型、尿微量白蛋白与肌酐比值 (albumin to creatinine ratio，ACR)及炎症因子之间的关系。方法 应用聚合酶链反应限制性片段长度多态性的方法及反向测序法检测108例 DN 患者CX3CR1-V249I多态性情况, 同时测定患者血浆同型半胱氨酸( Hcy) 、糖化血红蛋白( HbA1C) 、ACR、低密度脂蛋白（LDL）、核因子- κB（NF- κB）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、趋化因子Fractalkine（FKN）含量， 并记录患者的中医证型。结果 108例DN 患者中VV 型87例，VI 型17例，II 型4例。中医证型与CX3CR1 -V249I基因型之间具有相关性(χ2=10.136 ，P<0．05) , VV型基因多辨证为气阴两虚型, VI和II型以阴虚燥热为主。气阴两虚型、兼血瘀证患者具有更高的ACR水平( ACR水平(mg/g):（气阴两虚证 948.3±36.4）比（阴虚燥热证 919.3±31.5）, （气阴两虚证 948.3±36.4）比(阴阳两虚证921.8±37.9) 三组间比较F= 4.946， P<0．05；（血瘀证954.3±34.3）比（痰湿证921.5±36.9），（血瘀证954.3±34.3）比（湿热证917.8±37.1）三组间比较F= 7.283， P<0．05 )。CX3CR1-V249I基因突变与Hcy水平相关(t=3.601，P < 0. 05) ; 与ACR水平相关(t=2.692，P < 0. 05)。且V249I野生型患者较突变型患者NF- κB（0 .94 ±0 .16比0 .75 ±0 .17）、IL-6（170.75 ± 34.01 比147.43 ± 27.23）、TNF-α（95.91± 19.21 比 81.12 ± 13.50）含量要高(t值分别为7.926, 5.472，2.887， P< 0. 05)，FKN则在突变型患者表达更多(t=9.246, P< 0. 05)。结论 DN患者CX3CR1-V249I基因多态性与Hcy 、ACR、NF- κB、IL-6、TNF-α、FKN及中医证候相关。 |
| 英文摘要: |
| ABSTRACT Objective To explore the related factors of CX3CR1 Mutation and the relationship between CX3CR1 gene polymorphism and the different syndromes of TCM in the Type-2 diabetic nephropathy ( DN) . Methods By polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) and reverse sequencing method, CX3CR1gene polymorphism was analyzed in 108 patients with diabetic nephropathy. The levels of homocysteine ( Hcy ) , glycosy lated hemoglobin ( HbA1C) , albumin to creatinine ratio (ACR) , and the contents of NF-κb , FKN，IL-6 ，TNF-α in serum were detected respectively. The TCM syndromes were recorded Simultaneously. Results A total of 87 patients had VV wild genotype, and another 21 patients had non-wild genotype including 4 cases of homozygote. The genotype VV was mostly in the syndrome of qi and yin deficiency , and the genotype VI+II was mostly in the syndrome of yin deficiency with heat . Analysis showed that higher UAER level often revealed in patients with the syndrome of qi and yin deficiency or accompanying blood stasis syndrome(F=4.946，7.283； P<0．05).The CX3CR1 -V249I mutation was related with plasma Hcy level (t=3.601，P < 0. 05) and ACR level (t=2.692，P < 0. 05) . The contents of NF- κB、IL-6、TNF-α in serum increased significantly in the carriers withVV genotype than those with VI + II genotypes(t=7.926, 5.472，2.887， P< 0. 05)；But the contents of FKN decreased obviously in the carriers with VV genotypes than those with VI + II genotypes(t=9.246, P< 0. 05).Conclusion The CX3CR1 polymorphism in patient of type-2 DN was related with plasma Hcy ACR、NF- κB、IL-6、TNF-α、FKNlevels and TCM syndromes. |
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