高血压病人同型半胱氨酸与MTHFR 677C/T基因多态性相关性研究及不同剂量叶酸干预效果评价  

Study on the relationship between homocysteine and MTHFR 677C/T gene polymorphism in patients with hypertension and evaluation on the effect of different doses of folic acid intervention

作　　者：董文红 褚强强 章车明 张尧 吴政治 DONG Wen-hong;CHU Qiang-qiang;ZHANG Che-ming;ZHANG Yao;WU Zheng-zhi(Department of General Practice,The First People′s Hospital of Hefei,Hefei Anhui 230061,China)

机构地区：[1]安徽省合肥市第一人民医院全科医学科,230061

出　　处：《蚌埠医学院学报》2022年第3期334-336,339,共4页Journal of Bengbu Medical College

基　　金：安徽省合肥市医学重点学科建设资助项目(合卫科教2019160号)。

摘　　要：目的:探讨高血压病人同型半胱氨酸(Hcy)水平与MTHFR 677C/T基因多态性的相关性,评价不同剂量叶酸治疗不同基因型高Hcy血症效果。方法:筛选高血压病人359例,进行Hcy筛查及MTHFR 677C/T基因检测,根据基因类型分为CC型、CT型和TT型,每种基因类型筛选50例病人,随机分为2组,各25例,给予0.8 mg和5 mg叶酸治疗8周,评价治疗效果。结果:359例高血压病人中合并有高Hcy血症119例,发病率为55.43%。男性病人高Hcy血症发生率及血浆Hcy水平均明显高于女性(P<0.01)。MTHFR 677C/T基因检测结果显示,359例病人中CC型161例,CT型118例,TT型80例,TT型高血压病人发生高Hcy血症的比例及血浆Hcy均高于CC型和CT型(P<0.01)。干预前后同种基因型在0.8 mg组和5 mg组血浆Hcy水平差异无统计学意义(P>0.05)。0.8 mg组和5 mg组不同基因类型干预后的血浆Hcy水平较干预前均明显下降(P<0.01);干预后组内不同基因型Hcy水平差异有统计学意义(P<0.01),0.8 mg组和5 mg组中CC型Hcy水平低于CT和TT型(P<0.05);0.8 mg组CT型Hcy水平低于TT型(P<0.05)。结论:Hcy水平与MTHFR 677C/T基因多态性存在相关性,叶酸能有效降低Hcy水平,大剂量叶酸与较小剂量叶酸干预效果无明显差异。基因类型不同,叶酸干预效果存在差异。Objective:To investigate the correlation between homocysteine(Hcy)level and MTHFR 677C/T gene polymorphism in patients with hypertension,and evaluate the effect of different doses of folic acid on different genotypes of hyperhomocysteinemia.Methods:Three hundred and fifty-nine patients with hypertension were screened for Hcy screening and MTHFR 677C/T gene detection.The gene type was divided into type CC,CT and TT,and 50 patients in each gene type were randomly divided into two groups(25 cases in each group),who were treated with 0.8 mg and 5 mg folic acid for 8 weeks to evaluate the therapeutic effect.Results:Among 359 hypertensive patients,119 cases were combined with hyperhomocysteinemia,and the incidence rate was 55.43%.The incidence of hyperhomocysteinemia and plasma Hcy level in male patients were significantly higher than those in female patients(P<0.01).The results of MTHFR 677C/T gene detection showed that among 359 patients,161 cases were with type CC,118 cases were with type CT,and 80 cases were with type TT.The incidence of hyperhomocysteinemia and plasma Hcy level in type TT hypertensive patients were higher than those in type CC and type CT patients(P<0.01).There was no significant difference in plasma Hcy level between 0.8 mg group and 5 mg group of the same gene type before and after intervention(P>0.05).The plasma Hcy level in 0.8 mg group and 5 mg group of different gene type was significantly lower than those before intervention(P<0.01).The difference of Hcy level in different gene type in the same group after intervention was statistically significant(P<0.01),the Hcy level of type CC in 0.8 mg group and 5 mg group was lower than that of type CT and TT(P<0.05),and Hcy level of type CT in 0.8 mg group was lower than that of type TT(P<0.05).Conclusions:The Hcy level is correlated with MTHFR 677C/T gene polymorphism.Folic acid can effectively reduce hyperhomocysteinemia.There is no significant difference between high-dose folic acid and low-dose folic acid.The effect of folic acid intervention was

关 键 词：高血压 同型半胱氨酸 MTHFR 677C/T基因多态性 叶酸 

分 类 号：R544[医药卫生—心血管疾病]