两种中医体质高血压病患者的表型与α-内收蛋白基因多态性分型的关系  

Relationship between the Polymorphism of alpha-Adducin Gene and the Two Phenotypes of Constitutions in Patients with Essential Hypertension Classified by TCM

作　　者：钱岳晟[1] 张怡[1] 张伟忠[1] 周怀发[1] 茅守玉[1] 朱鼎良[1] 

机构地区：[1]上海交通大学附属瑞金医院上海市高血压研究所,上海200025

出　　处：《中国中西医结合杂志》2006年第8期698-701,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市卫生局科技发展基金(No.01466)

摘　　要：目的探讨高血压病患者阳亢和痰湿两种体质分类的表型,与α内收蛋白(alphaadducin,ADD1)基因多态性的分布作相关性分析。方法以收缩压(systolicbloodpressure,SBP)、舒张压(diastolicbloodpressure,DBP)、体重指数(bodymassindex,BMI)、空腹血糖(fastingbloodglucose,FBG)、肌酐(creatinine,Cr)、尿酸(uricacid,UA)、胆固醇(totalcholesterol,TC)、甘油三酯(triglycerides,TG)为观察指标,采用MALDITOF质谱检测技术进行ADD1Gly460Trp分型。结果207例高血压病患者按中医体质分型分为阳亢组113例,痰湿组94例;痰湿质高血压病患者在BMI、DBP、FBG、UA明显高于阳亢质高血压病患者;阳亢质和痰湿质高血压病患者ADD1基因GG型、GT型、TT型分别占29.2%、41.6%、29.2%和28.7%、48.9%、22.3%,差异无显著性(P>0.05),高血压的相关表型在3种基因分型中差异无显著性(P>0.05);TT型基因的阳亢组和痰湿组高血压病患者有4项指标差异显著,BMI(kg/m2)分别为24.11±3.04和26.20±2.30(P=0.01)、DBP(mmHg)分别为96.79±4.05和99.56±3.90(P=0.016)、FBG(mmol/L)分别为5.01±0.53和5.51±1.07(P=0.028)、UA(μmol/L)分别为302.22±71.95和358.25±88.75(P=0.028)。结论ADD1基因多态性的分布在2种不同体质的分类之间差异无显著性;带有ADD1TT型基因的痰湿质高血压病患者心脑血管危险因素更多,他们的预后可能要比阳亢质高血压病患者更差。Objective To investigate the relationship between the polymorphism of alpha-adducin （ADD1） gene and the two phenotypes of constitution in patients with essential hypertension, the Yang-hyperactive （YH） type and phlegm-dampness （PD） type, classified by traditional Chinese medicine （TCM） approach. Methods Two hundred and seven patients differentiated by TCM approach as YH type （ 113 cases） or PD type （94 cases） were observed, with the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, body mass index （BMI）, fasting blood glucose （FBG）, serum creatinine （Cr）, uric acid （UA）, total cholesterol （TC） and triglycerides （TG） as the criteria of observation. Gly460Trp polymorphism of the ADD1 gene was detected by MALDI-TOF mass spectrometry. Results The levels of BMI, DBP, FBG and UA, etc. in the PD group were significantly higher than those in the YH group respectively. The rate of GG, GT and TT type of ADD1 gene was 29.2% , 41.6% and 29.2% in the YH group, 28.7% , 48.9% and 22.3% in the PD group, showing no significant difference in ADD1 genotype distribution between the two groups, while there was also no difference in the hypertension phenotype distribution among different genotypes （both P 〉 0.05）. For the patients with TT genotype, there were significant differences between the YH group and the PD group in BMI （24.11 ± 3.04 kg/m^2vs26.20±2.30 kg/m^2）, DBP （96.79±4.05 mmHg vs 99.56± 3.90 mmHg）, FBG （5.01±0.53 mmol/L vs 5.51 ± 1.07 mmol/L） and UA level （302.22 ± 71.95 μmol/L vs 358.25 ± 88.75 μmol/L, all P 〈type, type. Conclusion There was no relation between ADD1 gene polymorphism and the TCM gcnotype of consti in patients with essential hypertension. However, it is likely that for hypertension patients with TT genothose of PD type are more susceptible to cardiovascular disease and have worse prognosis than those of YH type.

关 键 词：α-内收蛋白基因 基因多态性 原发性高血压 中医体质 阳亢 痰湿 

分 类 号：R259[医药卫生—中西医结合]