原发性高血压左心室肥厚患者AGT(M235T)、ACE(I/D)基因协同效应探讨  

The synergistic effects of ACE(I/D) and AGT(M235T) gene polymorphism on left ventricular hypertrophy in essential hypertension

作　　者：林婴[1] 杨明清[1] 黄文芳[1] 陶建虹[1] 尹立雪[1] 

机构地区：[1]四川省人民医院,四川成都610072

出　　处：《检验医学》2005年第2期121-125,共5页Laboratory Medicine

基　　金：四川省卫生厅科学研究基金资助(020001)

摘　　要：目的　探讨血管紧张素原(AGT)(M235T)、血管紧张素转换酶(ACE)(I/D)对原发性高血压(EH)患 者发生左心室肥厚(EH LVH)的基因协同效应。方法　对中国四川籍汉族人群中109例EH患者,采用聚合酶 链反应(PCR)以及PCR限制性片段长度多态性(RFLP)方法检测ACE(I/D)、AGT(M235T)基因多态性;利用超 声心动图检测左心室质量(LVM)并计算左心室质量指数(LVEI)。结果　ACE(I/D)基因多态性D等位基因频 率在EH LVH组中明显增高(χ2=4.69,P=0.030),男性EH患者中,ACE(I/D)基因型构成比与LVH有关联(χ2 =9.55,P=0.008),协同存在AGT TT时,ACE(I/D)基因多态性与EH LVH有关(χ2=6.22,P=0.044),且D等 位基因在EH LVH明显增高(χ2=6.91,P=0.009),该类EH患者发生LVH的相对危险度增高(OR:2.50,95% CI:1.25～5.00)。结论　ACE(I/D)基因多态性D等位基因可能是LVH的独立危险因子,ACE基因多态性与 AGT基因多态性之间的协同效应表明,同时携带AGT TT型时,具有ACE(I/D)基因多态性D等位基因的EH患 者更易发生LVH。Objective To investigate synergistic effects of gene polymorphisms of ACE(I/D) and AGT(M235T) on essential hypertension left ventricular hypertrophy (EH-LVH). Methods The gene polymorphism of ACE(I/D) was determined by polymerase chain reaction(PCR) and that of AGT(M235T) was determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) respectively in 109 patients with EH recruited from Sichuan Han population. Left ventricular mass(LVM) of 109 patients with EH was measured by echocardiography, and left ventricular mass index (LVMI) was calculated. Results The D allele of ACE(I/D) was significantly higher in EH-LVH group. There was relation between the genotype of ACE(I/D) and EH-LVH in male patients(χ 2= 9.55,P= 0.008). There was relation of ACE(I/D)genotype with EH-LVH carrying the AGT-TT genotype(χ 2= 6.22,P= 0.044),as well as the D allele in EH-LVH group was significantly higher than that in EH-non-LVH group carrying the AGT-TT genotype(χ 2= 6.91,P= 0.009). Moreover, the relative risk of LVH increased in these kinds of EH patients(OR: 2.50, 95%CI: 1.25- 5.00). Conclusions The synergistic effects of ACE and AGT gene polymorphism indicate that D allele of ACE(I/D) would be more susceptibile to EH-LVH carrying AGT-TT genotype by combined genotype analysis.

关 键 词：血管紧张素原 血管紧张素转换酶 基因 多态现象 高血压 左心室肥大 

分 类 号：R544.1[医药卫生—心血管疾病]