【摘要】 【目的】探讨中国南方部分汉族人群的冠心病患者中,肾素-血管紧张素系统中的关键成分即血管紧张素转换酶(ACE)及血管紧张素原(AGT)双基因多态性与冠心病合并慢性心力衰竭(CHF)发病的关系。【方法】应用聚合酶链反应及限制性片段长度多态性技术,对215例冠心病患者的ACE基因插入/缺失(I/D)及AGTM235T多态性进行检测。将其中105例合并CHF者作为病例组,其余110例心功能正常者作为对照组。【结果】冠心病合并CHF组DD基因型及D等位基因的频率均高于对照组(前者为45.7%vs23.6%,后者为64.8% vs 43.6%,P<0.01);AGT基因M235T多态性在两组中的分布无统计学差异;联合分析ACE与AGT基因多态性显示,两组中同时具有DD型ACE基因及TT型AGT基因的频率分别为27.6%及14.5%,前者明显高于后者。与Ⅱ+MM组合相比,具有该联合基因型的冠心病患者发生CHF的OR为5.039,较单基因ACEDD型发生CHF的OR增高。【结论】ACE基因I/D多态性与中国南方部分汉族人群冠心病患者发生CHF有关,DD型ACE基因可能是该地区CHF发病的遗传危险因素。单独的AGT基因M235T多态性似与该地区冠心病患者发生CHF无关,但联合ACE基因分析则发现,ACE和AGT基因在CHF的发生中具有协同作用,DD型基因的冠心病患者若同时携带有TT基因,发生CHF的机率增高。更多还原

【Abstract】 [Objective] To investigate the relationship between ACE and AGT gene polymorphisms and the onset of ischemic CHF in South Chinese population.[Methods] ACE gene I/D and AGT gene M235T polymorphisms were analyzed in 215 patients with coronary artery disease, the gene polymorphisms were detected by polymerase chain reaction and restriction fragment length polymorphism methods. Genotype distributions were examined in 105 consecutive patients with ischemic CHF and 110 patients with stable angina pectoris and LVEF > or = 45%.[Results] The frequencis of DD genotpye and D allele were higher in the patients with ischemic CHF than in their corresponding controls respectively(DD genotype: 45.7% vs 23.6%; D allele: 64.8%vs 43.6%, P < 0.01); The genotype distributions of AGT gene M235T were similar between the patients with and without CHF in CAD. In combined genotype analysis, the genotype of ACE DD+AGT TT was significantly higher in patients with ischemic CHF (27.6% vs 14.5%). The odds ratio estimated by the combined analysis of the ACE DD + AGT TT genotype was 5.039 compared with Ⅱ+ MM combinations, and it was higher than that estimated alone from ACE-DD genotype;[Conclusions] ACE gene I/D polymorphism plays a role in the development of CHF in CAD patients in South Chinese population, the DD genotype might be one of the genetic risk factors of CHF in this area; The AGT gene M235T polymorphism seems to have no correlation with the onset of CHF in CAD patients solely, but AGT and ACE gene might play an interaction role in the onset of CHF, combined analysis of the ACE-DD and AGT-TT genotype may enhance the predictability of CHF in CAD patients.更多还原