冠心病患者Apo(a)五核苷酸重复序列基因多态性及与血浆Lp(a)水平的关系  

The association of Pentanucleotide Repeat Polymorphism of Apolipoprotein (a)Gene and Plasma Lipoprotein (a)levels with coronary heart disease in chinese

作　　者：刘晓宁[1] 孙莉[2] 李昭晖[3] 高岩[4] 惠汝太 

机构地区：[1]中国医学科学院,北京100037 [2]中国协和医科大学 [3]心血管病研究所 [4]阜外心血管病医院 [5]中-德分子医学研究室

出　　处：《中国分子心脏病学杂志》2002年第3期3-6,共4页Molecular Cardiology of China

摘　　要：目的:探讨apo(a)五核苷酸重复序列(PNR)基因多态性在中国冠心病(CHD)患者中的分布情况及特点,分析其与血浆Lp(a)水平的关系。方法:采用聚合酶链反应(PCR)结合非变性聚丙烯酰胺凝胶电泳法(PAGE)检测了788例CHD患者(冠脉造影证实,其中心绞痛350例,心肌梗塞438例)及218例对照(冠脉造影阴性)的apo(a)PNR基因多态性,采用酶联免疫吸附法(ELISA)检测其血浆Lp(a)的水平。结果:三组人群apo(a)PNR共检出6种等位基因,以8最为常见,其次为9;检出16种基因型,常见的基因型依次为:8/8>8/9>5/8>9/9;心肌梗塞组(TTTTA)_5等位基因频率显著高于心绞痛组(P<0.01),(TTTTA)_(5/8)基因型频率显著高于对照组(P<0.05)和心绞痛组(P<0.01);其余各组之间等位基因和基因型频率比较均无显著性差异(P>0.05)。心肌梗塞组血浆Lp(a)浓度与apo(a)PNR基因多态性呈明显的负相关(r=-0.211,P<0.001),在对照组和心绞痛组中没有发现这种关联(P>0.05)。Logistic回归分析结果显示:血浆Lp(a)>30mg/dl者心绞痛的危险性增加(OR值为1.6,95％可信限为1.045～2.368),心肌梗塞的危险性增加(OR值为2.4,95％可信限为1.630～3.594),(TTTTA)_5和(TTTTA)_(5/8)与冠心病的关系没有统计学意义(P>0.05)。结论:血浆Lp(a)是冠心病独立的危险因素,apo(a)Objective The purpose of the study was to investigate the relation between Pentanucleotide （TTTTA）. repeat （PNTR） polymorphism of apolipoprotein （a） gene , plasma Lp （a） levels and chinese coronary heart disease （CHD）. Methods 788 patients with CHD （documented angioographically）and 218 control were recruited . The patients were subdivided into two group of angina and myocardial infarction （MI）according to their history. Plasma Lp （a）levels were measured with the method of ELISA and The PNR polymorphism of apo （a）gene was determined by polymerase chain reaction （PCR）-non-denature polyacrylamide gel electrophoresis. Results The frequencies of （TTTTA）s allele （7.8%）in MI group were remarkably higher than those in angina group （3.7%）, （TTTTA）s/s genotype （ 13.2% ）in MI group were remarkably higher than those in control group （7.8%）and angina group （6.3 % ）. A weakly yet significant negative correlation between the number of PNR and Lp （a）concentrations was observed in MI group （r = - 0.211, P 〈 0.001 ）. Multiple logistic regression analysis showed that there were close relationships between Lp （a）and angina （OR= 1.6, 95%CI： 1.045 - 2.368）and MI （OR= 2.4, 95%CI ：1.630 3.594）by adjustment for age, sex, SBP, DBP, BMI, smoking, TC, TG, HDL-C, LDL-C and Glu. Conclusion Lp （a）is an independent risk factor for CHD, Significant association between PNTR polymorphism of apolipoprotein （a）gene and Lp （a）concentrations was only observed in MI group.

关 键 词：apo(a) Lp(a) 危险因素 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]