李得春(1968~)，男，土族，青海籍，副主任医师

TNF-α基因多态性与藏族骨关节结核患者预后

李得春，陆川，张国秋

(青海大学附属医院骨关节外科)

摘要目的检测分析TNF-α基因多态性与藏族骨关节结核患者预后的关系，探讨TNF-α在判断藏族骨关节结核预后中的价值。方法采用酶联免疫吸附法(ELISA)检测青海地区藏族骨关节结核患者血清TNF-α表达水平，应用等位基因特异引物PCR(AS-PCR)分析TNF-α-308、TNF-α-238 位点启动子等位基因多态性，对受检患者进行随访，分析TNF-α表达在判断藏族骨关节患者预后中的价值。结果TNF-α在藏族骨关节结核患者血清中的表达水平(278.0±39.1ng/L)明显高于正常对照组(120.0±41.7ng/L)，差异具有统计学意义(P<0.05)；病例组TNF-α-308位点基因型及等位基因频率与对照组存在显著差异(P<0.05)，而TNF-α-238位点基因型及等位基因频率在青海地区藏族骨关节结核患者和对照组之间无显著差异(P>0.05)；TNF-α在判断藏族骨关节结核患者的预后中具有价值(P<0.05)。结论青海地区藏族骨关节结核患者中 TNF-α过度表达，且TNF-α-308基因多态性与青海地区藏族骨关节结核的发病可能存在关系；TNF-α表达水平可用来评估患者的预后，可作为藏族骨关节结核患者预后的标记物。

关键词骨关节结核肿瘤坏死因子α基因多态性藏族预后

中图分类号R322.7

文献标识码A

DOI：10.13452/j.cnki.jqmc.2015.03.002

AbstractObjectiveTo investigate the expression of TNF-α in osteoarticular tuberculosis of Tibetans，to test the associations between TNF-α-gene polymorphisms and OATB susceptibility in Tibetans and to clarify the prognosis value of TNF-α in the Tibetan patients with osteoarticular tuberculosis.Methods To detect the expression level of TNF-α in serum osteoarticular tuberculosis of Tibetans by using ELISA.To develop an allele-specific polymerase chain reaction(AS-PCR)assay to identify the polymorphisms of TNF-α-238 and-308 locus，to clarify the prognosis value of TNF-α in the Tibetan patients with osteoarticular tuberculosis.Results The expression level of TNF-α in Tibetan patients with osteoarticular tuberculosis(278.0±39.1ng/L)was significantly higher than that in normal control group(127±52.2ng/L)，with significant difference(P<0.05).TNF-α-308 locus distributions and their frequencies between the patients and controls show statistical significant.TNF-α-238 locus distributions and their frequencies between the patients and controls had no statistical significant.TNF-α could evaluate prognosis of OATB.Conclusion TNF-α is overexpressed in Tibetan patients with osteoarticular tuberculosis，and TNF-α-308 gene polymorphisms may be associated with susceptibility of OATB，and TNF-α can be used as marker for predicting the prognosis of OATB.

KeywordsOsteoarticular tuberculosisTumor necrosis factor-alphaGenetic susceptibilities TibetanPrognosis

收稿日期2015-01-03

THE RELATIONSHIP BETWEEN THE TUMOR NECROSIS

FACTOR-α GENE POLYMORPHISMS AND PROGNOSIS TO

OSTEOARTICULAR TUBERCULOSIS (OATB) IN TIBETANS

Li Dechun，Lu Chuan，Zhang Guoqiu

(Department of Joint，Qinghai University Affiliated Hospital，Xining 810001，China)

青海地区藏族骨关节结核发病率较高，其原因不明[1]。肿瘤坏死因子(TNF)-α主要由活化的巨噬细胞产生，是机体防御外界刺激的重要细胞因子，对机体的免疫细胞及免疫系统都具有重要作用[2]。TNF-α的基因多态性受地理环境、民族的影响。TNF-α基因多态性与藏族人群骨关节结核关系的报道较少且结论不一。本研究通过对青海地区藏族人群TNF-α基因多态性在骨关节结核发生发展过程中的表达与作用分析，厘清相关关系。

1资料与方法

1.1　研究对象

选取2009年01月～2011年12月在青海大学附属医院关节外科住院治疗的确诊为骨关节结核的青海籍81例藏族患者为病例组，其中男44例；……