急性心力衰竭患者MYNN基因rs1317082位点多态性对其预后的影响  

Prognostic effect of MYNN gene rs1317082 polymorphism in patients with acute heart failure

作　　者：李艳秀 张中文 郑旭辉 左祥荣 周艳丽[3] 张海峰[3] 李新立[3] 曹权 LI Yanxiu;ZHANG Zhongwen;ZHENG Xuhui;ZUO Xiangrong;ZHOU Yanli;ZHANG Haifeng;LI Xinli;CAO Quan(Department of Critical Care Medicine,First Affiliate Hospital of Nanjing Medical University,Nanjin,210029,China;Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Jiangning Hospital of Nanjing Medical University;Department of Cardiology,First Affiliate Hospital of Nanjing Medical University,Nanjin,210029,China)

机构地区：[1]南京医科大学第一附属医院重症医学科,南京210029 [2]南京医科大学附属江宁医院肝胆胰外科 [3]南京医科大学第一附属医院心血管内科

出　　处：《临床心血管病杂志》2021年第8期749-753,共5页Journal of Clinical Cardiology

基　　金：国家科技支撑计划课题(No:2011BAI11B08)。

摘　　要：目的:研究急性心力衰竭患者MYNN基因rs1317082位点多态性分布及其对预后的影响。方法:对2012—2016年在江苏省人民医院住院的325例急性心力衰竭患者进行长达1年的随访,定义随访终点为患者自入组开始至1年内的全因死亡。采用TaqMan探针法检测rs1317082位点的基因多态性,同时收集并比较不同基因型急性心力衰竭患者住院期间的基线资料情况,采用多因素Cox回归分析rs1317082基因多态性与急性心力衰竭患者预后的关系。结果:325例急性心力衰竭患者中,66例在随访期内发生死亡;GG基因型101例,AG基因型160例,AA基因型64例。不同基因型和携带不同等位基因的急性心力衰竭患者的死亡率差异有统计学意义(P<0.05)。基线资料比较显示,不同基因型急性心力衰竭患者心率、血清钾及治疗用药情况差异存在统计学意义(P<0.05)。Kaplan-Meier生存曲线分析显示,AA和AG基因型患者12个月生存率明显低于GG基因型(均P<0.05)。Cox回归分析显示,杂合子AG基因型和纯合子AA基因型的患者1年内发生死亡的风险分别为GG基因型的2.08倍(95%CI:1.05~4.09)和3.11倍(95%CI:1.49~6.49)。结论:MYNN基因的rs1317082位点多态性与急性心力衰竭患者短期预后有关,其AA和AG基因型是预测急性心力衰竭患者不良预后的独立危险因素。Objective:To investigate the MYNN gene rs1317082 polymorphism in patients with acute heart failure(AHF)and its effect on the prognosis.Methods:A total of 325 patients with AHF hospitalized in Jiangsu Provincial People’s Hospital from 2012 to 2016 were enrolled.All patients were followed up for one year,and the endpoint was all-cause death.The genetic polymorphism of the rs1317082 locus was analyzed by the TaqMan probe method.Baseline characteristics were collected and compared.Multivariate Cox regression was used to analyze the relationship between rs1317082 gene polymorphism and the prognosis.Results:Among 325 AHF patients,101 with GG genotype,160 with AG genotype,and 64 with AA genotype.Sixty-six patients died during follow-up.In different genotypes and different alleles,the mortality was significantly different(P<0.05).Baseline analysis showed statistically significant differences in heart rate,serum potassium,and medications in AHF patients with different genotypes(P<0.05).Kaplan-Meier survival curve analysis showed that the 12-month survival rate of AHF patients with genotypes AA and AG were significantly lower than those with genotype GG(both P<0.05).Cox regression analysis showed that AHF patients with heterozygous AG genotype[HR=2.08,95%CI:1.05-4.09]and homozygous mutant AA genotype[HR=3.11,95%CI:1.49-6.49]both had a significantly higher risk of death within 1 year than those with GG genotype.Conclusion:The rs1317082 polymorphism of the MYNN gene is related to the short-term prognosis of patients with AHF.Genotype AA and AG are independent risk factors for predicting a poor prognosis.

关 键 词：急性心力衰竭 rs1317082 预后 

分 类 号：R541.6[医药卫生—心血管疾病]