【摘要】 目的探讨β2肾上腺素能受体(β2-AR)Arg16Gly基因多态性及与职业精神紧张的交互作用对原发性高血压(EH)发生的影响。方法以职业紧张高暴露的男性行车人群为基础的1∶1病例对照研究(95对),调查职业紧张、紧张反应、焦虑、A型行为等职业精神紧张及高血压的常见危险因素,应用PCR-RFLP技术检测β2-ARArg16Gly基因多态性。采用似然比检验判断因素效应之间是否有相乘模型OR交互=OR11/(OR01×OR10)的交互作用。结果病例组和对照组的β2-AR16位点基因Arg/Arg、Arg/Gly、Gly/Gly频率分布有差异,具有统计学意义(P<0.05),在调整BMI等影响因素后,携带Gly/Gly的个体患EH的OR值为2.759(95%CI:1.200～6.347);携带突变型Arg16Gly基因与紧张反应、特质焦虑对原发性高血压影响的交互作用符合相乘模型,当携带突变型Arg16Gly基因与高紧张反应、特质焦虑同时存在时,其患EH的风险分别增加至12.797(95%CI:3.379～48.461),40.862(95%CI:1.403～119.057)。结论β2-AR基因Arg16Gly多态性很可能是职业紧张高暴露男性行车人群EH发生的重要易感因素;携带突变型Arg16Gly基因的个体,暴露于紧张反应和特质焦虑时,其原发性高血压发生的危险性显著增加。更多还原

【Abstract】 Objective To explore the role of the interaction between β2-adrenergic receptor(β2-AR)gene Arg16Gly polymorphism and occupational mental stress in EH.Methods Using 1∶1 case-control study,we select 95 couple people as the study objects from the high-exposure occupational stress males who work on the train.Measuring occupational stress、stress reaction,anxiety,type A behavior and other occupational mental stress by using proper questionnaire,and applying PCR-RFLP technology to detect adrenergic receptor(β2-AR)Arg16Gly Polymorphism.Using likelihood ratio test to judge whether it exist the interaction between the potencies and fits the multiplicative model:OR=OR_ 11/(OR_ 01×OR_ 10).Results The distribution of Arg/Arg,Arg/Gly,Gly/Gly in essential hypertension cases and controls are significant difference(P<0.05),Gly/Gly had a increased risk of hypertension 2.759(95%CI:1.200-6.347)compared to Arg/Arg upon controling BMI and other factors.The interaction among Arg16Gly(A/G+G/G)gene、occupational stress reaction and anxiety is fit the multiplicative model.The results showed that when Arg16Gly(A/G+G/G)genotype interact with strain,the risk of EH will add to 12.797(95%CI:3.379-48.461).When it interact with anxiety,the risk of EH will add to 40.862(95%CI:1.403-119.057).Conclusion Arg16Gly polymorphism of β2-AR might be the crucial risk factor for EH among high-exposure occupational stress males.Individual who has genotype Gly/Gly,while exposure of strain and T-Anxiety is much easier to get EH.更多还原