MYNN rs10936599基因多态性与急性心力衰竭患者短期预后的相关性  

Correlation analysis of MYNN gene polymorphism in rs10936599 region and the prognosis of patients with acute heart failure

作　　者：李艳秀 张中文 刘云 左祥荣 李新立 曹权 Li Yanxiu;Zhang Zhongwen;Liu Yun;Zuo Xiangrong;Li Xinli;Cao Quan(Department of Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211100,China;Department of Cardiovascular Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院重症医学科,210029 [2]南京医科大学第一附属医院心血管内科,210029 [3]南京医科大学附属江宁医院肝胆胰外科,211100

出　　处：《中华重症医学电子杂志》2021年第3期208-213,共6页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：国家科技支撑计划项目课题(2011BAI11B08)。

摘　　要：目的探讨MYNN基因的rs10936599位点多态性与急性心力衰竭(AHF)患者预后的关系。方法选取2012年3月至2016年3月于南京医科大学第一附属医院心血管内科住院的AHF患者328例,采用TaqMan探针法对MYNN基因的SNP位点rs10936599(T/C)进行基因多态性检测,记录并比较不同基因型患者(TT基因型、CT基因型、CC基因型)住院期间的人口学特征、临床资料、病因和伴随疾病、住院期间治疗用药等基线资料,并对所有患者进行12个月的前瞻性随访,随访终点为全因死亡。分析rs10936599位点多态性对AHF预后的影响。结果(1)rs10936599基因型频率分布:TT基因型100例(占30.5%),CT基因型162例(占49.4%),CC基因型66例(占20.1%);rs10936599位点的基因型和等位基因频率在死亡患者和存活患者间比较,差异有统计学意义(χ^(2)=9.749,P=0.0076;χ^(2)=9.641,P=0.0019)。(2)心率、血清钾水平及住院期间地高辛和醛固酮拮抗剂使用情况在不同基因型患者间比较,差异有统计学意义(H=7.714,P=0.021;F=3.254,P=0.040);其他基线资料在不同基因型患者间比较,差异无统计学意义(P>0.05)。(3)Kaplan-Meier曲线分析显示携带等位基因C(CC/CT)的AHF患者12个月生存率较TT基因型患者明显下降,差异有统计学意义(TT vs CT,P=0.026;TT vs CC,P=0.002)。(4)进一步Cox回归分析结果显示杂合子CT基因型和纯合子CC基因型是影响AHF患者预后的独立危险因素(HR=2.10,95%CI:1.07~4.12;HR=2.96,95%CI:1.42~6.19)。结论MYNN基因rs10936599位点多态性与AHF患者预后有关,CC和CT基因型是预测AHF患者12个月不良预后的独立危险因素。Objective To investigate the relationship between the rs10936599 polymorphism of MYNN gene and the prognosis of patients with acute heart failure(AHF).Methods A total of 328 hospitalized patients with AHF from 2012 to 2016 were prospectively enrolled.Patients were followed up to 12 months.The primary outcome was all-cause mortality.The SNP locus rs10936599(T/C)of the MYNN gene were analyzed by TaqMan method.Baseline characteristics were compared between groups which divided based on the different genotypes(TT genotype,CT genotype,CC genotype).Cox Regression analysis were used to identify the association between rs10936599 and outcome.Results(1)Frequency distribution of rs10936599 genotype:there were 100 cases of homozygous TT genotype(30.5%),162 cases of heterozygous CT genotype(49.4%),66 cases of mutation homozygous CC genotype(20.1%);AHFpatients with different genotypes had a significant difference of 12-month mortality(χ^(2)=9.749,P=0.0076;χ^(2)=9.641,P=0.0019).(2)Baseline characteristics comparison among different genotypes showed a significant difference of the heart rate,serum potassium,and medications of Digoxin and Aldosterone antagonist during hospitalization(H=7.714,P=0.021;F=3.254,P=0.040).(3)Kaplan-Meier analysis showed the 12-month survival rate of patients with AHF carrying allele C(CC/CT)was significantly lower than that of patients with TT genotype(TT vs CT,P=0.026;TT vs CC,P=0.002).(4)Cox regression analysis showed that homozygous CT genotype and heterozygous CC genotype were independent risk factors for the death of patients with acute heart failure(HR=2.10,95%CI:1.07-4.12;HR=2.96,95%CI:1.42-6.19).Conclusion MYNN rs10936599 gene polymorphisms are associated with the 12-month mortality of patients with AHF.CC and CT genotype are independent risk factors of 12-month mortality of AHF.

关 键 词：MYNN基因 rs10936599 急性心力衰竭 预后 

分 类 号：R541.6[医药卫生—心血管疾病]