血管紧张素转换酶基因多态性与我国慢性心力衰竭易感性分析  

Gene polymorphism of angiotensin-converting enzyme and susceptibility to chronic heart failure in China

作　　者：白强[1] 胡紫薇 兰晓栋 高积慧[1] Bai Qiang;Hu Ziwei;Lan Xiaodong;Gao Jihui(Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005,China;不详)

机构地区：[1]湖南中医药大学第二附属医院,长沙410005 [2]湖南中医药大学循证医学中心,长沙410005

出　　处：《中国循证心血管医学杂志》2020年第11期1311-1315,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：湖南省自然科学基金(2018JJ6036);湖南省中医药管理局课题(201641)。

摘　　要：目的通过Meta分析评价血管紧张素转换酶(ACE)基因多态性与我国慢性心力衰竭的关联性。方法检索PubMed、EMbase、CNKI、CBM、VIP和WanFang等6大数据库,搜集国内外ACE基因I/D基因多态性与心力衰竭发病风险关联性的病例-对照研究或队列研究,检索时间截止为2019年10月1日;此外,检索纳入文献及相关综述的参考文献,并在Google及百度学术进行检索,补充未纳入上述数据库文献。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata13.0软件进行Meta分析。结果最终纳入13个病例-对照研究,包括纳入心力衰竭患者1524例,健康对照1576例,合计样本量为3100例。Meta分析结果显示,D等位基因增加HF患者风险,差异有显著性(OR=1.684,95%CI:1.466~1.936,P=0.02)。对各基因模型进行分析结果为:DD vs.II模型(OR=2.295,95%CI:1.893~2.782,P=0.02);DD vs.DI+II模型(OR=1.971,95%CI:1.679~2.313,P=0.000);DD+DI vs.II模型(OR=1.593,95%CI:1.364~1.861,P=0.006)。基于地区的亚组分析显示,中国内陆地区(广东、福建、海南、山东、辽宁、湖南、湖北)人群ACE基因多态性与慢性心力衰竭发病风险有相关性。结论基于目前的相关研究结果,认为中国内陆地区ACE基因(I/D)多态性与心力衰竭易感性有相关性,但本研究结论仍需优化的多中心、大样本量的研究进行验证。Objective To analyze and review the relevance between gene polymorphism of angiotensinconverting enzyme(ACE)and chronic heart failure(CHF)in China by applying Meta-analysis.Methods The databases of PubMed,EMbase,CNKI,CBM,VIP and WanFang Data were retrieved for searching the case-control studies or cohort studies on the relevance between gene polymorphism of I/D gene of ACE and CHF at home and abroad,and the deadline was Oct.1,2019.In addition,the references of included literature and related reviews,and Google and Baidu Academic were retrieved for supplementing the documents not included in the above databases.The literature was screened,data was extracted and risk of bias was reviewed in included studies by 2 researchers independently.A Meta-analysis was conducted by applying Stata13.0 software.Results There were totally 13 casecontrol studies included involved 1524 CHF patients,1576 healthy controls,and the total sample size included 3100 cases.The results of Meta-analysis showed that D allele increased CHF risk(OR=1.684,95%CI:1.466~1.936,P=0.02).The results of analyzing on different gene models were as follows:DD vs.II model(OR=2.295,95%CI:1.893~2.782,P=0.02),DD vs.DI+II model(OR=1.971,95%CI:1.679~2.313,P=0.000),and DD+DI vs.II model(OR=1.593,95%CI:1.364~1.861,P=0.006).The results of subgroup analysis based on regions showed that there was a correlation between gene polymorphism of ACE and CHF risk in the population of Chinese inland areas(Guangdong,Fujian,Hainan,Shandong,Liaoning,Hunan and Hubei).Conclusion Based on the current relevant research results,it is believed that gene polymorphism of ACE(I/D)is correlated to CHF susceptibility in Chinese inland areas,but the conclusion of this study still needs to be verified with optimized studies with multi-center and large sample size.

关 键 词：血管紧张素转换酶 基因多态性 心力衰竭 META分析 

分 类 号：R541.61[医药卫生—心血管疾病]