亚甲基四氢叶酸还原酶基因多态性对H型高血压患者同型半胱氨酸及冠状动脉病变的影响  

Effect of MTHFR gene polymorphism on serum homocysteine level and coronary artery lesions in H-type hypertension patients

作　　者：苏晓叶[1] 李小波[2] 邢俊武[1] 钱春发[1] 李敏[1] 伯广干 张代民[2] Su Xiaoye;Li Xiaobo;Xing Junwu;Qian Chunfa;Li Min;Bo Guanggan;Zhang Daiming(Department of Cardiology,Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing 210014,Jiangsu Province,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院心内科,210014 [2]南京医科大学附属南京医院心内科

出　　处：《中华老年心脑血管病杂志》2019年第8期826-829,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：江苏省2018省级重点研发计划项目(BE2018611);南京市医学科技发展项目(YKK14160)

摘　　要：目的探讨H型高血压患者亚甲基四氢叶酸还原酶(MTHFR)基因多态性分布与血浆同型半胱氨酸(Hcy)水平及冠状动脉病变的关系。方法收集2017年1月~2019年1月南京市中西医结合医院心内科及南京医科大学附属南京医院心内科收治的H型高血压患者300例(观察组),同期选取非H型高血压患者100例(对照组),所有患者行冠状动脉造影检查,测定Hcy水平,并进行基因检测。结果观察组双支病变、3支病变、狭窄>69%、左回旋支、右冠状动脉病变及Gensini评分明显高于对照组,差异有统计学意义(P<0.05,P<0.01)。观察组TT型明显高于对照组,CC型明显低于对照组,差异有统计学意义(P<0.01)。2组等位基因频率比较,差异有统计学意义(P<0.01)。观察组TT型冠状动脉病变支数、狭窄程度较CT型和CC型严重,TT型主要以左回旋支和右冠动脉病变受累,差异有统计学意义(P<0.01)。观察组TT型Hcy水平最高,其次为CT型和CC型,差异有统计学意义[(21.7±3.9)μmol/L vs (18.3±1.9)μmol/L、(16.6±1.7)μmol/L,P<0.05]。观察组Hcy水平与冠状动脉狭窄程度和Gensini评分呈正相关(r=0.318,P=0.003;r=0.256,P=0.017)。结论 H型高血压患者冠状动脉病变程度重,且以左回旋支和右冠动脉受累为主,MTHFR 677C/T基因型以TT型为主,TT型Hcy处于高水平且冠状动脉病变严重。Objective To study the distribution of MTHFR gene polymorphism in H-type hypertension patients and its relationship with serum homocysteine(Hcy)level and coronary artery lesions.Methods Three hundred H-type hypertension patients admitted to our hospital from January 2017 to January 2019 served as an observation group and 100 non H-type hypertension patients served as a control group.The patients in two groups underwent coronary angiography.Their serum Hcy levels were measured and their genes were detected.Results The incidence of two and three-vessel disease,stenosis>69%,left circumflex branch lesions,right coronary artery lesions and the Gensini score were significantly higher in observation group than in control group(P<0.05,P<0.01).The frequency of TT-type genotype was significantly higher while that of CC-type genotype was significantly lower in observation group than in control group(P<0.01).The frequency of alleles was different in 2 groups(P<0.01).The number of injured coronary artery branches was greater and the stenosis of coronary artery was severer in patients with TT genotype than in those with CT genotype and CC genotype(P<0.01).The left circumflex branch and right coronary artery lesions occurred mainly in patients with TT genotype(P<0.05).The serum Hcy level was positively related with the coronary artery stenosis and Gensini score in observation group(r=0.318,P=0.003;r=0.256,P=0.017).Conclusion Coronary artery lesions are severe in H-type hypertension patients with the right coronary artery and left circumflex artery involved.The MTHFR 677 C/T genotype is mainly presensented as TT genotype and the serum Hcy level is high in patiemts with TT genotype.

关 键 词：亚甲基四氢叶酸还原酶(NADPH) 多态性 单核苷酸 高半胱氨酸 高血压 基因频率 冠状动脉狭窄 

分 类 号：R544.1[医药卫生—心血管疾病]