不稳定型心绞痛患者血管紧张素转换酶基因多态性与中医证型及冠状动脉斑块性质的关系  

The Relationship Between Angiotensin Converting Enzyme Gene Polymorphism,TCM Syndrome and Coronary Artery Plaque Characteristic in Patients with Unstable Angina Pectoris

作　　者：邵静[1] 朱晓萌[1] 

机构地区：[1]河南中医学院第一附属医院,河南省郑州市人民路19号450000

出　　处：《中医杂志》2015年第19期1671-1674,共4页Journal of Traditional Chinese Medicine

基　　金：河南省二〇一二年科技发展计划(122102310079)

摘　　要：目的观察不同中医证型及冠状动脉斑块性质的不稳定型心绞痛患者血管紧张素转换酶(ACE)基因多态性分布规律。方法收集240例不稳定型心绞痛患者,气虚血瘀证38例,气滞血瘀证24例,痰阻心脉证19例,心血瘀阻证39例,阴寒凝滞证18例,气阴两虚证23例,心肾阴虚证32例,阳气虚衰证47例。另收集健康志愿者60例作为对照。采用聚合酶链反应(PCR)技术检测其ACE等位基因插入/缺失(I/D)及ACE基因型,采用多层螺旋CT判断冠状动脉斑块的硬化程度,分析不同中医证型及冠状动脉斑块性质的不稳定型心绞痛患者ACE基因多态性分布规律。结果 240例不稳定型心绞痛患者冠状动脉软斑块者120例、中等密度斑块者54例、钙化斑块者66例。不稳定型心绞痛患者ACE-DD基因型者32.9%(79例),显著高于健康志愿者的15%(9例)(P<0.05);不稳定型心绞痛患者D等位基因者54.2%(130例),较健康志愿者的46.7%(28例)显著升高(P<0.05)。气虚血瘀证、痰阻心脉证、心血瘀阻证患者中DD基因型分布显著高于健康志愿者(P<0.01),气滞血瘀证、气阴两虚证患者中ACE-ID基因型分布显著高于健康志愿者(P<0.01)。心血瘀阻证、痰阻心脉证、气阴两虚证患者中D等位基因染色体数显著高于健康志愿者(P<0.01)。冠状动脉软斑块者与中等密度斑块者ACE-DD基因型比例均显著高于钙化斑块者(P<0.05)。结论 ACE基因DD基因型及D等位基因可能是冠心病不稳定心绞痛的易感基因,且在中医辨证之气虚血瘀证、痰阻心脉证、心血瘀阻证患者中分布较多,ACE-DD基因型在软斑块及中等密度斑块患者中分布较多。Objective To observe distribution rules of angiotensin converting enzyme （ACE） gene polymorphism in patients with unstable angina pectoris according to different TCM syndrome and coronary artery plaque characteristic. Methods Collected 240 cases of patients suffering from unstable angina pectoris, with 38 cases of Qi-deficency and blood-stasis syndrome, 24 cases of Qi-stagnation and blood-stasis syndrome, 19 cases of phlegm blocking heart vessel syndrome, 39 cases of heart blood stasis syndrome, 18 cases of Yin-cold stagnation syndrome, 23 cases of Qi and Yin deficiency syndrome, 32 cases of heart and kidney Yin deficiency syndrome, 47 cases of vital energy faded syndrome. Besides, collected 60 cases of healthy volunteers as control group. Adopted polymerase chain reaction （PCR） technique to examine its ACE allele inserting/deleting （I/D） and ACE genotype. Adopted Multi-slice helical CT the evaluate the degree of coronary artery plague hardening. Analyzed distribution rules of ACE gene polymorphism of patients suffering from unstable angina pectoris according to different TCM syndrome and coronary artery plaque characteristic. Results There were 120 cases of coronary artery soft plaque, 54 cases of medimn density plaque, 66 cases of calcified plaque in 240 cases of patients suffering from unstable angina pectoris. There were 32.9% （79 cases） ACE-DD genotype in patients suffering from unstable angina pectoris, remarkably superior to 15% （9 cases） in healthy volunteers （P 〈 0. 05 ） ; There were 54.2% （ 130 cases） D allele in patients suffering from unstable angina pectoris, remarkably superior to 46.7% （28 cases） in healthy volunteers （P 〈 0. 05 ）; DD genotype obviously had more people in Qi-deficency and blood-stasis syndrome, phlegm blocking heart vessel syndrome, heart blood stasis syndrome than in healthy volunteers （ P 〈 0. 01 ）. ACE-ID genotype obviously had more people in blood-stasis syn- drome, Qi and Yin deficiency than in healthy volunteers （ P 〈 0. 01 �

关 键 词：不稳定型心绞痛 血管紧张素转换酶 基因多态性 中医证候 冠状动脉斑块 

分 类 号：R259[医药卫生—中西医结合]