冠心病痰瘀证与载脂蛋白E基因多态性关系的研究  

Study on relationship between polymorphism of apolipoprotein E gene and syndromes of phlegm and blood stasis in patients with coronary heart disease

作　　者：欧阳涛[1] 宋剑南[1] 苗阳[2] 林谦[3] 牛晓红[1] 金红[1] 陈冰[1] 

机构地区：[1]中国中医研究院基础理论研究所生化室 [2]中国中医研究院西苑医院心内科,北京100091 [3]北京中医药大学东方医院心内科,北京100078

出　　处：《中西医结合学报》2005年第6期438-442,共5页Journal of Chinese Integrative Medicine

基　　金：国家自然科学基金资助项目(No.30171128);国家重点基础研究发展计划资助项目(No.2003CB517105)

摘　　要：目的:探讨冠心病(coronary heart disease,CHD)不同痰瘀证候与载脂蛋白E(apolipoprotein E,ApoE)基因第4外显子多态性的关系。方法:选择符合条件的CHD痰证、瘀证、痰瘀互阻证和非痰非瘀证(其他证型)患者200例,另选100名健康志愿者作为对照。常规检测所有样品的血脂水平。提取全血DNA,用聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length poly-morphism,PCR-RFLP)技术检测ApoE基因型。采用SAS软件对基因多态性和痰瘀证候的辨证类型进行相关性分析。结果:(1)冠心病患者中ε4等位基因频率(19.5%)明显高于健康对照组(9.5%),具有统计学意义(P<0.05),其中尤以E 3/4基因型更为多见(P<0.01)。(2)携带ε4等位基因者的总胆固醇(totalcholesterol,TC)、总甘油三酯(total triglycerides,TG)和低密度脂蛋白胆固醇(low-density lipoproteincholesterol,LDL-C)水平明显高于非携带者(P<0.01)。(3)痰证特别是E3/4基因型患者中E3/4型和ε4等位基因的频率明显高于血瘀证患者(P<0.05)。结论:ApoEε4等位基因是冠心病的危险因素,携带此基因的患者与痰证关系较为密切,推测其可能是CHD痰证的主要易感基因之一。Objective： To explore the relationship between polymorphism of apolipoprotein E （ApoE） exon 4 gene and different syndromes in patients with coronary heart disease （CHD）. Methods： Two hundred patients with CHD were divided into four groups according to syndrome differentiation, including syndrome of phlegm （PS）, syndrome of blood stasis （BSS）, syndrome of phlegm-blood stasis blocking （PBBS） and syndrome of non-phlegm and non-blood stasis （NPNBS）. One hundred healthy volunteers were included in control group. Blood lipids were measured by routine examination. Total DNA of peripheral blood was extracted. ApoE genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） technique. All data were analyzed by SAS software. Results： （1）The occurrence rate of ε4 allele of ApoE in patients with CHD was 19.5%, significantly higher than 9.5% in the control group （P〈 0.05）, and the E 3/4 genotype was especially more frequent （P〈0. 01 ）. （2） The levels of total cholesterol （TC）, total triglycerides （TG） and low-density lipoprotein cholesterol （LDL-C） in patients with ε4 were higher than those in patients without ε4 （P〈0.01）. （3） The frequencies of ε4 allele and E3/4 genotype in patients with PS were significantly higher than those in patients with BSS （P〈0.05）. Conclusion： ApoE ε4 allele, especially E3/4 genotype, is the risk factor of CHD. There is a relatively close relationship between patients with ApoE ε4 allele and PS. It may be one of the main susceptible genes in CHD patients with PS.

关 键 词：冠心病 载脂蛋白E类 基因多态性 痰瘀证候 

分 类 号：R259[医药卫生—中西医结合]