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目的探讨复发性流产与人类白细胞抗原DQB1(HLA-DQB1)基因多态性的关系。方法应用PCR限制性片段长度多态性方法(PCR-RFLP),分析36例无不良妊娠史的正常妇女(对照组)和61例复发性流产患者[观察组,其中抗心磷脂抗体阳性31例,抗心磷脂抗体阴性30例;早期流产28例,晚期流产22例,早晚期流产(2次以上的流产分别发生在早期或晚期)11例]的DQB1基因型。结果(1)观察组0201等位基因频率为16·4%(20/122),明显高于对照组的8·3%(6/72),但两组比较,差异无统计学意义(P>0·05);观察组DQB1第57位非天门冬氨酸频率明显高于对照组,两组比较,差异有统计学意义(P<0·05);观察组中早期流产者0201等位基因频率为23·2%(13/56),明显高于晚期流产者的4·5%(2/44),两者比较,差异有统计学意义(P<0·05);晚期流产者0303等位基因频率为27·3%(12/44),明显高于早期流产者的7·1%(4/56),两者比较,差异也有统计学意义(P<0·05)。(2)观察组中抗心磷脂抗体阳性者0303等位基因频率为26%(16/62),明显高于抗心磷脂抗体阴性者的7%(4/60),两者比较,差异有统计学意义(P<0·05)。结论DQB1第57位非天门冬氨酸可能与复发性流产的发生有关,DQB1*0201等位基因可能与早期流产有关,DQB1*0303等位基因可能与晚期流产及抗心磷脂抗体阳性者的流产发生有关。
Objective To investigate the relationship between recurrent spontaneous abortion and human leukocyte antigen DQB1 (HLA-DQB1) gene polymorphism. Methods PCR-RFLP was used to analyze 36 healthy women (control group) with no history of adverse pregnancy and 61 patients with recurrent spontaneous abortion (observation group, 31 patients were positive for anticardiolipin antibody , Anti-cardiolipin antibodies negative in 30 cases; early abortion in 28 cases, 22 cases of late abortion, early and late abortion (more than 2 abortion occurred in early or late, respectively) 11 cases of DQB1 genotype. Results (1) The allele frequency of 0201 in the observation group was 16.4% (20/122), significantly higher than that in the control group (8.3%) (6/72), but there was no significant difference between the two groups (P > 0.05). The frequency of 57th non-aspartic acid in DQB1 in observation group was significantly higher than that in control group, with significant difference between the two groups (P <0.05); in the observation group, the frequency of 0201 The gene frequency was 23.2% (13/56), significantly higher than 4.5% (2/44) of those with advanced abortion, the difference was statistically significant (P <0.05); late abortion The frequency of 0303 allele was 27.3% (12/44), which was significantly higher than that of early abortion (7.1%, 4/56). There was also a significant difference between the two groups (P <0.05). (2) In the observation group, the frequency of 0303 allele was 26% (16/62) in anticardiolipin antibody positive group and significantly higher than 7% (4/60) in anticardiolipin antibody negative group, the difference was Statistical significance (P <0.05). Conclusion The 57th non-aspartic acid in DQB1 may be related to the occurrence of recurrent spontaneous abortion. The DQB1 * 0201 allele may be related to early miscarriage. The DQB1 * 0303 allele may be associated with the abortion of late abortion and anticardiolipin antibodies It happened.