Dissertation
Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)

The Significance of Atineutrophil Cytoplasmic Antibody Testing and HLA-DRB1Gene Polymorphisms Research in the Diagnosis of Stroke

Author LuXiangFeng
Tutor WangPeiChang
School Capital University of Medical Sciences
Course Clinical Laboratory Science
Keywords anti-neutrophil cytoplastic antibody stroke HLA-DRB1gene
CLC R743.3
Type Master's thesis
Year 2013
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BackgroundWith the accelerated process of global aging, occurrence rate of cerebrovasculardisease is also increasing, thus the research of the cause of such disease, mechanismof disease prevention, treatment detection gradually become the hot spot, and thelooking for a specific marker and susceptibility genes are the basis of the above work.It is found in previous study that anti-neutrophil cytoplasmic antibodies can affectnervous system in70%of patients, which is mainly because vascular supplyingnerves cause vasculitis, and thus leading to ischemia.;The genotype of HLA-DRB1are closely linked with anti-neutrophil cytoplasmic antibodies, which is the main genecausing the positive gene. At present, there are13genotypes in this gene.Then whatis the relationship between anti-neutrophil cytoplasmic antibodies and stroke disease?Then which genotype is a susceptibility gene for stroke onset? This research, takesstroke patients as the research material and analyzes the relationship between themand anti-neutrophil cytoplasmic antibodies, and through the research of the morbiditydifference of stroke patients in different HLA-DRB1alleles, it looks for susceptiblegene causing stroke.ObjectiveIt researches ANCA-positive rate, clinical baseline data and difference betweenclinical baseline data and other laboratory parameters of stroke in young group andthe middle and elderly group. At the same time, it researches polymorphism of HLA-DRB1genne and susceptibility genes that cause disease, thus providing scienceevidence for prevention, early diagnosis and treatment of stroke.Methods1. It has retrospective analysis of clinical baseline data and routine examinationindicators in laboratory of patients with stroke and analyzes the differences betweenthe youth group and the middle and elderly group, ANCA-positive group withANCA-negative group.2. Collecting blood of20ANCA-positive patients with stroke and20ANCA-negativepatients with stroke and healthy people, to extract the DNA typing of them. Andthrough the typing of HLA-DRB1gene, it analyzes the differences between the threegroups.Result1. The ANCA positive incidence (50.98%) in young stroke patients is higher thanthat (42.46%) in quinquagenarian group, and the difference is statistically significant(p <0.05), but the history of diabetes(59.46%) and the history of hypertension(40.54%) are higher than that in the young group (19.23%,11.53%), and thedifference was statistically significant.2. The erythrocyte sedimentation rates(ESR:22.33±3.87mm/h), C-reactive proteinCRP:1.34±0.98mg/dl),Immunoglobulin(IgG:1237.25±481.61mg/dl) are higher inthe ANCA-positive youth group than these (ESR:6.20±1.18mm/h, CRP:0.41±0.12mg/dl, IgG:1014.48±224.79mg/dl) are in the ANCA-negative youth group.The difference is statistically significant (p<0.05). These indicators (ESR:24.54±3.85mm/h,CRP:1.26±0.94mg/dl,IgG:1299.97±475.17mg/dl)in ANCA-positivequinquagenarian group than these (ESR:13.92±2.12mm/h, CRP:0.35±0.26mg/dl,IgG:1081.30±249.97mg/dl) in ANCA-negative quinquagenarian group.Thedifference is statistically significant (p <0.05). 3. HLA-DRB1alleles are detected11genotypes in the Beijing area population:HLA-DRB1*01,03,04,07,08,09,11,12,13,14,15,but not detected HLA-DRB1*10,16;The higher detection rate of genotypes are HLA-DRB1*07(16.67%),HLA-DRB1*14(15.00%), HLA-DRB1*04(12.50%), HLA-DRB1*11(12.50%),HLA-DRB1*12(11.67%), HLA-DRB1*13(10.00%), which are accounting for78.34%.4. The frequency of HLA-DRB1*07,13,14genotypes in three goups is similar.Thefrequency of HLA-DRB1*4,11genotype is lower in the ANCA-positive youth groupthan other two goups,while HLA-DRB1*12significantly higher,which suggestes thatthe HLA-DRB1*12is the impotant genotype in Beijing ANCA positive stokepatients.Conclusions1. The incidence in young group is higher than that in quinquagenarian group.Itpromptes that ANCA may be some connection with stroke in patients about age.2. ESR, IgG and CRP indicators in ANCA-positive patients are higher than these inthe ANCA-negative patients. It describes that these indicators may has isotropic orpositive association with ANCA.3. HLA-DRB1*12allele may be a disease-causing gene in stroke with positiveanti-neutrophil cytoplasmic antibodie of Beijing.

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