【摘要】 目的探讨糖尿病视网膜病变(diabeticretinopathy,DR)中医证型及其证型与亚甲基四氢叶酸还原酶(methylenetrahydrofolatereductase,MTHFR)基因、肾素血管紧张素Ⅰ转移酶(angiotensinI-convertingenzyme,ACE-1)基因多态性的相关性。方法用流行病学研究方法研究DR的主要临床证型;并用聚合链酶反应-限制性片段(polymerasechainreaction-restrictionfragmentlengthpolymorphism,PCR-RFLP)和聚合链酶反应(polymerasechainreaction,PCR)技术检测245例不同中医证型的MTHFR、ACE基因多态性。结果气阴两虚、阴虚内热、脾虚湿热、阴阳两虚、脾虚痰湿五证的合并证,占总例数的97.55%;DR患者阴阳两虚证、脾虚痰湿证组MTHFR基因的TT型基因频率和T等位基因的携带率较其它证型组明显增加,CC型基因频率和C等位基因携带率明显下降,ACE基因DD型基因频率和D等位基因的携带率明显增加、Ⅱ型基因频率和I等位基因携带率明显下降,差异均有显著性意义(P<0.05,P<0.01);而脾虚痰湿证与阴阳两虚证组比较,MTHFR、ACE基因各种基因型频率分布差异均无显著性(均P>0.05)。结论气阴两虚、阴虚内热、脾虚湿热、阴阳两虚、脾虚痰湿五证的合并证为DR的主要证型;阴阳两虚证组、脾虚痰湿证组与MTHFR基因C677T位点突变、ACE缺失型多态性表达密切相关。更多还原

【Abstract】 OBJECTIVE Study the main clinical syndrome differentiation types(SDT)of the patients with diabetic retinopathy(DR)and correlativityrelationship between SDT and methylenetrahydrofolate reductase(MTHFR)gene polymorphisms angiotensin I-converting enzyme(ACE-1)gene polymorphism.METHODS Epidemic disease investigating methods were applied in the syndrome-differentiation of 245 patients with DR by MTHFR genetic C677T polymorphisms and ACE gene polymorphism were determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)and polymerase chain reaction(PCR).RESULTS Thefrequency of qiyinliangxu(气阴两虚),yingxuneire(阴虚内热),pixushire(脾虚湿热),yinyangliangxu(阴阳两虚),and pixutanshi(脾虚痰湿)aretogether were 97.55%.The frequencies of MTHFR genotype TT and allele T,ACE gene DD type and allele D were significantly higher in yingyangliangxu group and pixutianshi group than other syndrome types.The differentiation has statistical significance(P<0.05,P<0.01),and comparing the two groups,the frequencies of MTHFR and ACE genotype has no statistical significance(P>0.05).CONCLUSIONS Qiyinliangxu,yingxuneire,pixushire,yinyangliangxu,and pixutanshi are the main syndromes differentiation of DR.Yinyangliangxu and pixutanshi have strong association with MTHFR gene C677T mutation,associated with polymorphism of ACE.更多还原