非缺血性心肌病继发慢性心力衰竭患者载脂蛋白E-ε基因多态性与曲美他嗪治疗预后的相关性  

Correlation between apolipoprotein E-ε gene polymorphisms and prognosis of trimetazidine treatment in patients with non-ischemic cardiomyopathy and secondary chronic heart failure

作　　者：武乐[1] 刘利艳[1] Wu Le;Liu Liyan(Jiangxi Tumor Hospital,Nanchang 330029,Chin)

机构地区：[1]江西省肿瘤医院,南昌330029

出　　处：《临床内科杂志》2018年第7期476-480,共5页Journal of Clinical Internal Medicine

摘　　要：目的探讨非缺血性心肌病（（NICM））继发慢性心力衰竭（CHF）患者载脂蛋白E（ApoE）-ε基因多态性与曲美他嗪治疗预后的相关性。方法选取NICM继发CHF患者110例，均接受曲美他嗪治疗，根据1年后的预后将其分为生存组（71例）与死亡组（39例）。抽取患者静脉血并提取白细胞基因组DNA，采用聚合酶链反应（PCR）-限制性片断长度多态性技术（RFLP）检测两组患者ApoE-ε基因型和等位基因。采用彩色多普勒心脏超声检测所有患者的左心室射血分数（LVEF）和左心室舒张末内径（LVEDD）并进行比较。应用多元logistic回归分析评估ApoE基因8多态性与患者预后的相关性。结果死亡组ε3／4、ε4／4及ε2／3基因型患者比例高于生存组，82／4基因型患者比例低于生存组（P〈0．05）。死亡组等位基因ε4出现频率高于生存组，ε2出现频率低于生存组（P〈0．05），而两组间83出现频率无统计学差异（P〉0．05）。多元logistic回归分析结果显示，ε4／4基因型和4等位基因是曲美他嗪治疗NICM继发CHF患者预后不良的危险因素（P〈0．05）。随访1年时生存组6种基因型患者的LVEF及LVEDD比较，差异均有统计学意义（P〈0．05），且ε2／2基因型患者LVEF〉ε2／3〉ε2／4〉ε3／3〉ε3／4〉ε4／4，82／2基因型患者LVEDD〈ε2／3〈ε2／4〈ε3／3〈ε3／4〈ε4／4（P〈0．05）。结论NICM继发CHF患者ApoE-ε基因多态性与曲美他嗪治疗的预后密切相关，ε4／4基因型或ε4等位基因是其预后不良的危险因素。Objective To explore the correlation between apolipoprotein （Apo） E-ε gene polymorphisms and prognosis of trimetazidine treatment in patients with non-ischemic eardiomyopathy （NICM） and secondary chronic heart failure（CHF）. Methods A total of 110 patients with NICM and secondary CHF received trimetazidine treatment. All patients were divided into survival group （71 eases） and death group（39 cases） according to the prognosis after one year. The geuome DNA of WBC in venous blood were extracted. The ApoE-ε genotypes and alleles in two groups were detected by polymerase chain reaction （PCR）-restrietion fragment length polymorphism （RFLP）. Left ventricular ejection function （LVEF） and left ventricular end-diastolic dimension （LVEDD） were measured by cardiac color Doppler ultrasound. The relationships between ApoE-ε gene polymorphisms and prognosis of patients were analyzed by multivariate logistic regression analysis. Results Rates of patients with ε3/4, ε4/4 and ε2/3 genotype in death group were higher than those in survival group, and rates of patients with ε2/4 genotype was lower （ P 〈 0.05 ）. Allele frequency of ε4 in death group was higher than that in survival group, while allele frequency of ε2 was lower（P 〈 0.05 ） ,but allele frequency of ε3 between the two groups were not significantly different（P 〉 0.05 ）. Multivariate logistic regression analysis showed that ε4/4 genotype and ε4 allele were risk factors of poor prognosis of trimetazidine treatment in patients with NICM and secondary CHF （ P 〈 0.05 ）. LVEF and LVEDD among 6 kinds of genotypes in survival group at one year of following up were significantly different（ P 〉 0.05 ） , and LVEF of patients with e2/2 genotype 〉 ε2/3 〉 ε2/4 〉ε3/3 〉ε3/4 〉ε4/4, LVEDD of patients with ε2/2 genotype 〈ε2/3 〈ε2/4 〈 ε3/3 〈ε3/4 〈ε4/4 （ P 〈 0.05 ）. Conclusion ApoE-ε gene polymorphism is closely related to the prognosis of trimetazidine treatment in patients wit

关 键 词：非缺血性心肌病 慢性心力衰竭 载脂蛋白E 基因多态性 曲美他嗪 

分 类 号：R541.61[医药卫生—心血管疾病]