【摘要】 目的探讨云南汉族原发性高血压伴左室肥厚(EH-LVH)和左室扩大(EH-LVD)与HLA-DRB1等位基因的相关性。方法采用PCR-SSP技术对云南汉族91例健康个体和91例高血压病患者进行HLA-DRB1等位基因分型,并对其进行二维超声和M型超声检查有无LVH和LVD。应用Logistic回归分析原发性高血压伴左室肥厚的可能的易患因素。结果1.高血压伴左室肥厚(EH-LVH+)组中HLA-DR15(DRB1*1501/2)频率明显高于高血压不伴左室肥厚(EH-LVH-)组(34.9%VS10.4%,P=0.000,RR=4.601)和对照组(34.9%VS6.0%,P=0.000,RR=8.330);而DR9(DRB1*0901)的频率明显低于EH-LVH-组(2.3%VS10.4%,P=0.028,RR=0.205)和对照组(2.3%VS19.2%,P=0.000,RR=0.100);2.Logistic回归分析显示,HLA-DR15等位基因、病程及收缩压对原发性高血压伴左室肥厚(EH-LVH)有作用,比值比(OR)值分别为6.067,1.263,1.220;3.HLA-DRB1等位基因频率在高血压伴左室扩大组(EH-LVD+)与高血压不伴左室扩大组(EH-LVD-)的比较无统计学意义。结论HLA-DR15(DRB1*1501/2)等位基因可能是云南汉族EH-LVH的易感基因;HLA-DR9(DRB1*0901)等位基因可能是EH-LVH的保护基因。HLA-DR15等位基因、病程、收缩压均是引起EH-LVH的危险因素。更多还原

【Abstract】 Objective To explore the relationship between the essential hypertension (EH)with left ventricular remodeling including left ventricular hypertrophy(LVH)and left ventricular dilation(LVD)and the polymorphism of HLA-DRB1 alleles in Yunnan Han Nationals. Methods The alleles of HLA-DR of 91 healthy subjects and 91 hypertensive patients in Yunnan Han Nationals were determined by polymerase chain reaction sequence specific primers (PCR-SSP),and their cardiac structure was measured by echocardiography and left ventricular mass index (LVMI)was calculated. Finally,the risk factors of LVH were analyzed by logistic regression. Results The frequency of HLA-DR15 (DRB1*1501/2)of essential hypertension with left ventricular hypertrophy (EH-LVH+)group was significantly higher than that of the essential hypertension without left ventricular hypertrophy(EH-LVH-)group(P< 0.001)and control group (P =0.000).But the frequency of HLA-DR9 (DRB1*0901)of the EH-LVH+ was significantly lower than that of the EH-LVH-group (P<0.05)and control group (P=0.000). The HLA-DR15 (DRB1*1501/2),course of hypertensive disease and systolic pressure were related to LVH by logistic regression analysis. The frequency of HLA-DRB1 alleles had no difference between the EH-LVD+ group and the EH-LVD-group in Yunnan Han Nationals. Conclusion It is possible that the HLA-DR15 is a susceptible gene of EH-LVH; HLA-DR9 is a protective gene of EH-LVH. Logistic regression shows the course of EH,systolic pressure and HLA-DR15 all are possible risk factors of EH-LVH.更多还原