目的 探讨细胞毒性T淋巴细胞相关抗原-4(CTLA-4) (AT)n多态性与儿童过敏性紫癜的相关性.方法 选取2014年1月至2015年12月在西安交通大学第一附属医院住院诊断为过敏性紫癜的患儿60例为病例组,另选取健康普查的30例健康儿童作为对照组.采用ABI3130xl测序仪进行毛细管电泳对第4外显子3'端的AT重复序列进行基因分型.分析微卫星的等位基因频率在各组间的分布.结果 ①微卫星(AT)n在病例组和对照组共检出等位基因19种,AT重复次数5～ 34不等,当AT重复次数为16时,等位基因频率在病例组与对照组间差异有统计学意义(P =0.034,OR=2.115,95％ CI:1.049 ～4.267);②微卫星(AT)n按有无肾脏损害分层:各等位基因频率在有肾脏损害的过敏性紫癜(HSPN)组与无肾脏损害的过敏性紫癜(NHSPN)组差异均无统计学意义(均P＞0.05);③微卫星(AT)n按性别分层:当AT重复次数为15时,等位基因频率在男女两组间差异有统计学意义(P=0.014,OR=0.210,95％ CI:0.055～0.805).结论 CTLA-4 (AT)n基因多态性与过敏性紫癜(HSP)发病相关,AT基因重复次数为16时可能为HSP发病的易感基因,重复次数为15时可能为女性HSP患儿发病的易感基因.%Objective To investigate the association between cytotoxic T lymphocyte associated antigen-4 (CTLA-4) (AT)n gene polymorphism and Henoch-schonlein purpura (HSP) in children.Methods Sixty children diagnosed as HSP in the First Affiliated Hospital of Xi'an Jiaotong University from January 2014 to October 2015 were enrolled in case group.Thirty healthy children receiving health examination were enrolled in control group.Genotyping of 3'untranslated region of exon 4 was performed using capillary electrophoresis with ABI3130xl.Distribution of allele frequencies of microsatellite in different groups was analyzed.Results Totally 19 allele of microsatellite (AT)n were detected in both groups,among which AT repeated from 5 to 34 times.Significant difference was indicated in the comparison of allele frequencies between two groups when the repetition of AT was 16 (P =0.034,OR =2.115,95％ CI:1.049-4.267).Microsatellite (AT)n was delaminated according to whether there was kidney damage,and there was no statistical significance in allele frequency between HSPN and NHSPN (P ＞ 0.05).Microsatellite (AT)n was delaminated according to gender,and there was statistical significance in allele frequency between male and female when AT rcpeated for 15 times (P =0.014,OR =0.210,95％ CI:0.055-0.805).Conclusion CTLA-4 (AT) n is associated with the susceptibility of HSP.Allele in which AT repeats 16 times may be the susceptible factor of HSP;and allelc in which AT repeats 15 times may be the susceptible factor of HSP for female patients.
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