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-  2015 

维生素D受体基因Bsm Ⅰ位点多态性对维持性血液透析患者骨代谢的影响 Effects of Vitamin D Receptor Gene BsmⅠ Polymorphism on Renal Osteodystropy in Hemodialysis Patients

Keywords: 维生素D受体,基因多态性,维持性血液透析,骨代谢

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Abstract:

目的:探讨维生素D受体(VDR)BsmⅠ基因多态性对湖北地区汉族人群维持性血液透析(MHD)患者骨代谢的影响。方法:记录120例MHD患者一般临床资料和临床常用血生化指标;双能X线吸收测定法测定患者桡骨骨密度;聚合酶链反应-限制性片断长度多态性(PCR-RFLP)技术检测BsmⅠ基因型和等位基因频率;ELISA法测定血清25-(OH)D3水平。结果:MHD患者BB基因型2.5%,Bb基因型31.7%,bb基因型65.8%,B等位基因频率18.4%,b等位基因频率81.6%。BB+Bb基因型患者全段甲状旁腺激素(iPTH)和碱性磷酸酶(ALP)水平明显升高,桡骨骨密度显著下降,与bb型比较差异有统计学意义(P<0.05);与iPTH<150pg/ml组比较,BB+Bb基因型频率在iPTH 300-600pg/ml组显著升高(χ2=10.81,P<0.005);iPTH 300-600pg/ml组B等位基因频率显著上升,与iPTH<150pg/ml组和iPTH 150-300pg/ml组比较差异有统计学意义(χ2=11.43,χ2=7.11,P<0.01)。B等位基因与iPTH(r=0.47,P<0.05)和ALP(r=0.52,P<0.05)显著正相关,与桡骨骨密度(r=-0.36,P<0.05)显著负相关。结论:B等位基因可能为湖北汉族MHD患者遗传易感基因,通过改变VDR敏感性或影响甲状旁腺功能导致透析患者发生骨代谢异常

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