血管紧张素转换酶2基因多态性与高血压合并脑卒中患者的预后分析  

Relationship of angiotensin-converting enzyme 2 gene polymorphism with the prognosis of hypertensive stroke patients

作　　者：莫与京 黄文晖[1,2] 陈东骊[1,2] 陈富荣 

机构地区：[1]广东省医学科学院 [2]广东省人民医院广东省心血管病研究所心内科,广东广州510080

出　　处：《南方医科大学学报》2010年第1期84-87,共4页Journal of Southern Medical University

基　　金：广州市科技计划项目(2007J1-C0221)

摘　　要：目的研究血管紧张素转化酶2(ACE2)基因G9570A多态性与我国南方汉族人原发性高血压合并脑卒中的预后的关系。方法采用聚合酶链反应和限制性片段长度多态性(PCR-RFLP)的方法,检测141例原发性高血压合并脑卒中患者,与156例单纯原发性高血压患者做比较,并在2年随访期间对高血压合并脑卒中患者进行随访,描述患者病后生存状况,应用Kaplan-Meier法进行生存率分析,采用Cox比例风险回归模型对ACE2基因多态性和影响患者死亡的临床危险因素进行生存分析。结果原发性高血压合并脑卒中组A等位基因频率分布高于原发性高血压组,差异有统计学意义(P<0.01);两组ACE2基因型分布不同,AA基因型的频率较高,差异有统计学意义(P<0.01)。Kapan-Meier生存分析结果显示:各组ACE2基因型患者的无病生存率没有显著性差异(P>0.05)。Cox回归分析结果显示:年龄(RR=1.057,95%CI:1.020,1.095)、糖尿病(RR=1.575,95%CI:1.178,2.104)、高甘油三脂血症(RR=1.947,95%CI:1.503,2.780)和血清肌酐水平(RR=1.034,95%CI:1.001,1.068)、血清尿酸水平(RR=1.056,95%CI:1.002,1.097)分别是影响原发性高血压合并脑卒中男性和女性患者无病生存率的独立危险因素(P<0.05)。结论ACE2基因G9570A多态性与我国南方汉族人原发性高血压合并脑卒中可能具有一定相关性,但与其预后关系不大。年龄、糖尿病、高甘油三脂血症和血清肌酐、尿酸水平分别是影响男性和女性高血压合并脑卒中预后的独立危险因素。Objective To study the relationship between angiotensin-converting enzyme 2 （ACE2） gene G9570A polymorphisms and the clinical outcome of stroke patients with essential hypertension （EH） in South China Han population. Method The ACE2 gene polymorphisms were detected in 141 stroke patients with EH and 156 patients with EH using polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP）. The genetic marker was tested for its association with the baseline measurements and clinical outcomes of the patients over a median follow-up period of 22 months. As the ACE2 gene is X-linked, analyses were performed for male and female patients separately. Results The A allele frequency in the stroke patients was significantly different from that in the EH patients, and the AA allele frequency in the female patients was significantly different between the two groups （P0.01）. Kaplan-Meier model analysis showed that ACE2 gene polymorphism was not associated with the the patients＇ prognosis （P0.05）. Multivariate Cox＇s proportional hazard regression model identified age （RR=1.057, 95% CI： 1.020, 1.095）, blood glucose （RR=1.575, 95% CI： 1.178, 2.104）, hypertriglyceridemia （RR=1.947, 95%CI： 1.503, 2.780）, blood creatinine （RR=1.034, 95%CI： 1.001, 1.068）, and blood uric acid （RR=1.056, 95%CI： 1.002, 1.097） as the risk factors associated with the mortality. Conclusion Stroke occurs more likely in hypertensive patients carrying the A/AA allele than those carrying other alleles. The ACE2 gene G9570A polymorphisms may be associated with the occurrence of stroke in EH patients in South China, but may not have a strong correlation to the prognosis.

关 键 词：血管紧张素转化酶2 基因多态性 高血压 脑卒中 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]