【摘要】 目的:研究三磷酸腺苷结合盒转运子A1(ABCA1)R219K基因多态性和AMI患者血脂水平关系以及他汀药物调脂疗效与患者不同基因型的关系。方法:AMI患者(150例),其中ST段抬高型心肌梗死120例,非ST段抬高性心肌梗死30例,对照组(100例)为门诊健康体检者,均清晨空腹采血,测定血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)。并采用聚合酶链式反应-限制性片段长度多态性(PCR-RFIP)方法对R219K基因多态性进行检测,AMI患者给与普伐他汀40 mg/d,12周后重复测定上述血脂水平。结果:ABCA1基因的R219K多态性基因型频率和等位基因频率在对照组和AMI组相似(P>0.05);AMI患者中RR基因型较KK基因型具有明显升高的血清TG水平和较低的HDL-C水平(P<0.05);KK基因型患者较RR基因型患者相比,普伐他汀治疗明显增加HDL-C水平(P<0.05)。结论:ABCA1基因的R219K多态性与血脂水平相关,并且可影响AMI患者HDL-C水平对普伐他汀的治疗效果。更多还原

【Abstract】 AIM: To investigate the effects of the R219K polymorphism of ATP-binding cassette transporter A1(ABCA1) gene on serum lipid levels and the response to statin therapy in patients with acute myocardial infarction(AMI).METHODS: A total of 250 subjects were studied(150 cases with AMI and 100 controls without signs or symptoms of coronary heart disease).AMI patients were treated with pravastatin(40 mg/day).Fasting serum lipids were determined before and after 12 weeks of treatment.Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).RESULTS: The R219K polymorphism of ABCA1 gene was not significantly associated with AMI(P>0.05).Compared with controls,patients with the RR genotypes had significantly higher serum triglyceride(TG) levels and lower high-density lipoprotein cholesterol(HDL-C) levels than those with the KK genotypes(P<0.05).The effects of pravastatin to increase HDL-C levels were significantly better in KK homozygous patients compared with patients with RR-homozygous patients(P<0.05).CONCLUSION: The R219K polymorphism of ABCA1 is associated with altered lipoprotein levels and R219K variant significantly modulates the HDL-C response to pravastatin in patients with AMI.更多还原