乙醛脱氢酶2基因多态性与血管内皮功能及动脉粥样硬化关系的研究  

The association between aldehyde dehydrogenase 2 gene polymorphism and endothelial function as well as atherosclerosis

作　　者：李瑞建[1] 陈玉国[1] 张运[2] 孙祎[1] 徐峰[1] 吕瑞娟[1] 巩会平[2] 

机构地区：[1]教育部和卫生部心血管重构与功能研究重点实验室,山东大学齐鲁医院急诊科,济南250012 [2]教育部和卫生部心血管重构与功能研究重点实验室,山东大学齐鲁医院心内科,济南250012

出　　处：《中华超声影像学杂志》2007年第5期389-392,共4页Chinese Journal of Ultrasonography

摘　　要：目的 应用高分辨力超声技术对肱动脉舒张功能及血流动力学进行评价，并结合定量冠状动脉（冠脉）造影结果，探讨乙醛脱氢酶2（ALDH2）基因多态性与血管内皮功能及动脉粥样硬化之间关系。方法 150例经冠脉造影证实的冠心病患者，根据基因测序结果分为A组（野生型）93例（62％）和B组（突变型）57例（38％），观察两组患者冠心病易患因素及冠状动脉病变程度，同时应用高分辨力超声技术评价肱动脉舒张功能及相应状态下血流最大剪切率。结果两组患者基本临床特征比较差异无统计学意义（P〉0．05）。B组患者多支病变率显著低于A组（57．9％对76．4％，P=0．017），Gensini评分亦低于A组（46．3±35．7对61．8±49．3，P=0．04）。高分辨力超声检查：肱动脉基础内径两组间差异无统计学意义（P〉0．05）。内皮依赖性血管舒张功能检查：反应性充血后肱动脉内径变化两组间差异无统计学意义（P〉0．05）；非内皮依赖性血管舒张功能检查：含化硝酸甘油后B组血管内径的增幅较A组显著减少（P〈0．05），表明B组患者对硝酸酯类药物反应能力较低。脉冲多普勒检查血流动力学，基础状态及反应性充血后肱动脉最大剪切率A组显著低于B组（P〈0．01），提示野生型患者易发生动脉粥样硬化。结论ALDH2基因多态性与血管内皮功能及动脉粥样硬化之间关系密切。ALDH2基因突变虽可导致非内皮依赖性血管舒张功能障碍，但内皮依赖性血管舒张功能不受影响。ALDH2基因突变可能具有抗动脉粥样硬化的作用。Objective To evaluate the effect of aldehyde dehydrogenase 2（ALDH2） gene polymorphism on endothelial function and atherosclerosis. Methods One hundred and fifty patients with coronary artery disease, which were identified by coronary angiography, were enrolled in this study. They were divided into two groups according to the genotypes of ALDH2 ： wide-type group （ ＊ 1/1,93 cases） and mutant group （ ＊ 1/2 and ＊ 2/2,57 cases）. The hrachial artery vasodilatation and maximum shear rate were measured by high resolution ultrasound. Results Baseline clinical characteristics were similar between two groups （ P 〉0.05）. Compared with group A, the patients with multi-vessel disease in group B were significantly fewer （57.9% vs 76.4%, P = 0.017） ,and the Gensini score was also lower （46.3 - 35.7 vs 61.8 - 49.3, P = 0.04）. High resolution ultrasound of brachial artery showed that there was no difference in the diameter at rest between two groups （ P 〉 0.05）, and the diameter during reactive hyperemia （flow mediated dilation, FMD） was also similar between two groups （ P 〉0.05） ,however,the diameter after sublingual administration of nitroglycerin （non-flow mediated dilation, NMD） was significantly less in group B than in group A （ P 〈0.05）. In addition, the maximum shear rates at rest and during reactive hyperemia were less in group A compared to group B （ P 〈0.01）. Conclusions ALDH2 gene polymorphism has a close relationship with endothelial function and atherosclerosis. The mutant in ALDH2 gene leads to impaired NMD in vivo while contributes to anti-atherosclerosis,but has no influence on FMD.

关 键 词：超声检查 动脉硬化 内皮 血管 醛脱氢酶 

分 类 号：R686[医药卫生—骨科学]