血管紧张素转化酶基因I/D多态性与维吾尔族高血压合并阻塞性睡眠呼吸暂停低通气综合征患者左心室肥厚的关系  

Relationship between angiotensin-converting enzyme gene insertion/deletion polymorphisms and left ventricular hypertrophy in Uygur patients with hypertension and obstructive sleep apnea hypopnea syndrome

作　　者：孙晓靖[1] 布买热木.买提库尔班 陈玉岚[2] 珠勒皮亚.司马义 徐新娟[2] 张俊仕[2] 张向阳[2] Sun Xiaojing;Bumairemu Maitikuerban;Chen Yulan;Zhulepiya Simayi;Xu Xinjuan;Zhang Junshi;Zhang Xiangyang(Department of Intensive Care Unit,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China;Department of Hypertension,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第二附属医院重症医学科,乌鲁木齐830063 [2]新疆医科大学第一附属医院高血压科,乌鲁木齐830054

出　　处：《中华诊断学电子杂志》2018年第4期236-241,共6页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：新疆维吾尔自治区自然科学基金(2015211C038)

摘　　要：目的探讨血管紧张素转化酶(ACE)基因插入/缺失(I/D)多态性与维吾尔族高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者左心室肥厚(LVH)的关系。方法选取2015年1月至2016年12月于新疆医科大学第一附属医院高血压科首诊住院,且未服用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)类降压药物的维吾尔族高血压合并OSAHS患者,共72例,行多导睡眠呼吸监测、动态血压、心脏彩超等检查,聚合酶链式反应(PCR)和琼脂糖凝胶电泳技术测定ACE基因多态性。根据左心室质量指数分为左心室肥厚组(LVH组,n=24)和非左心室肥厚组(NLVH组,n=48),比较两组间基因型及基因频率的差异,使用多因素Logistic回归分析左心室肥厚的影响因素。结果高血压合并OSAHS患者LVH组ACE基因型频率分别为:Ⅱ(37. 50%),ID (20. 83%),DD (41. 67%),等位基因频率分别为:I (48. 00%),D (52. 00%),与NLVH组[Ⅱ(47. 92%),ID(37. 50%),DD(14. 58%),I(67. 00%),D(33. 00%)]比较,差异有统计学意义(χ~2=6. 75,4. 70;均P <0. 05);对左心室肥厚影响因素进行多因素Logistic回归分析,呼吸暂停低通气指数(AHI)(OR=6. 20,95%CI:1. 44～26. 77; P <0. 05)、DD基因型(OR=4. 61,95%CI:1. 05～20. 31; P<0. 05)是维吾尔族高血压合并OSAHS患者发生LVH的独立危险因素。结论 ACE基因I/D多态性与维吾尔族高血压合并OSAHS患者发生LVH有关,其中DD基因型维吾尔族患者更易发生LVH。Objective To explore the association of angiotensin converting enzyme（ACE） gene insertion/ deletion （I/D） polymorphism with left ventricular hypertrophy in Uygur hypertension-OSAHS patients. Methods Seventy-two Uygur hypertension-OSAHS patients without taking ACEI/ARB antihypertensive drugs and newly diagnosed of hypertension in the First Affiliated Hospital of Xinjiang Medical University between January 2015 and December 2016 were selected. All patients underwent polymorphic sleep monitoring, 24 h ambulatory blood pressure monitoring, echocardiography, and PCR, agarose gel electrophoresis were applied to determine genotype and allele frequency of ACE gene.To group by computing left ventricular mass index, the differences of genotype and gene frequency were used and the riskfactors for left ventricular hypertrophy were analysed via Logistic regression. Results In hypertension-OSAHS patients, the frequencies of II, ID, DD genotypes were 37.50%,20.83%,41.67%, respectively, and I, D allele frequencies were 48.00%,52.00% in LVH group. In NLVH group, the frequencies of II, ID, DD genotypes were 47.92%,37.50%,14.58%, respectively, and I, D allele frequencies were 67.00%, 33.00%. There were significant differences in ACE gene polymorphisms between LVH group and NLVH group in hypertension- OSAHS patients （ χ 2 =6.75,4.70, all P 〈0.05）. Logistic regression analysis showed that apnea hypopnea index （AHI）（ OR =6.20,95% CI ：1.44-26.77, P 〈0.05）,DD genotype（ OR = 4.61,95% CI ： 1.05- 20.31, P 〈0.05）were the independent risk factors for LVH in Uygur hypertension-OSAHS patients. Conclusions The ACE I/D polymorphisms are associated with the development of left ventricular hypertrophy in Uyghur hypertension- OSAHS patients and the DD genotype Uygur patients are more likely to have left ventricular hypertrophy.

关 键 词：血管紧张素转化酶基因 肥厚 左心室 高血压 睡眠呼吸暂停  阻塞性 多态性 单核苷酸 

分 类 号：R544.1[医药卫生—心血管疾病] R766[医药卫生—内科学]