H型高血压患者MTHFR基因C677T位点多态性检测的临床价值  

Clinical value of MTHFR gene C677T polymorphism determination in patients with H-type hypertension

作　　者：王珊 徐旻一 王微[2] 蒋明明 卢培[2] 熊仲波 王蕾[2] WANG Shan;XU Minyi;WANG Wei;JIANG Mingming;LU Pei;XIONG Zhongbo;WANG Lei(Department of Clinical Laboratory,the People's Hospital of Wenshang County,Jining 272500,Shandong,China;Department of Clinical Laboratory,Shanghai Eighth People's Hospital,Xuhui Branch of Shanghai Sixth People's Hospital,Shanghai 200235,China)

机构地区：[1]汶上县人民医院检验科,山东济宁272500 [2]上海市第八人民医院上海市第六人民医院徐汇分院检验科,上海200235

出　　处：《检验医学》2022年第11期1012-1016,共5页Laboratory Medicine

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C677T位点多态性检测的临床价值。方法采用数字荧光分子杂交法检测215例高血压患者及113名健康体检者(正常对照组)的MTHFR基因C677T位点多态性,同时测定血清同型半胱氨酸(Hcy)水平。根据Hcy水平将高血压患者分为H型高血压组(143例)和非H型高血压组(72例)。按高血压的严重程度分为Ⅰ级高血压组(48例)、Ⅱ级高血压组(77例)和Ⅲ级高血压组(90例)。检测H型高血压患者采用叶酸治疗前、治疗6个月后的血清Hcy水平。结果H型高血压组血清Hcy水平显著高于非H型高血压组和正常对照组(P<0.01)。Ⅲ级高血压组血清Hcy水平显著高于Ⅱ级高血压组和Ⅰ级高血压组(P<0.05)。H型高血压组CC、TT基因型频率及C、T等位基因频率与非H型高血压组、正常对照组比较,差异均有统计学意义(P<0.05)。Ⅱ级高血压组、Ⅲ级高血压组TT基因型频率及T等位基因频率均显著高于Ⅰ级高血压组(P<0.05)。TT基因型H型高血压患者血清Hcy水平显著高于CC基因型患者和CT基因型患者(P<0.01)。不同基因型的H型高血压患者采用叶酸治疗后血清Hcy水平均低于治疗前(P<0.05)。TT基因型的H型高血压患者叶酸治疗前、后血清Hcy水平均显著高于CT基因型患者和CC基因型患者(P<0.01)。结论MTHFR基因C677T位点多态性与高血压的严重程度有关。检测MTHFR基因C677T位点变异对于H型高血压患者的个体化治疗疗效评估有较高的临床价值。Objective To investigate the clinical value of methylenetetrahydrofolate reductase(MTHFR)gene C677T polymorphism determination in H-type hypertension.Methods The MTHFR gene C677T polymorphism was determined by digital fluorescence molecular hybridization in 215 patients with hypertension and 113 healthy subjects,and the levels of serum homocysteine(Hcy)were determined.The patients with hypertension were classified into H-type group(143 cases)and non-H-type hypertension group(72 cases)according to Hcy levels.According to the severity of hypertension,they were classified into GradeⅠ,ⅡandⅢgroups(48,77 and 90 cases,respectively).Serum Hcy levels were determined in patients with H-type hypertension before and after folic acid treatment for 6 months.Results Serum Hcy level in H-type hypertension group was higher than those in non-Htype hypertension group and healthy control group(P<0.01).Serum Hcy level in GradeⅢhypertension group was higher than those in GradeⅡand GradeⅠhypertension groups(P<0.05).The frequencies of CC,TT genotype and C,T allele in H-type hypertension group were higher than those in non-H-type hypertension group and healthy control group(P<0.05).The frequencies of TT genotype and T allele in GradeⅡand GradeⅢhypertension group were higher than those in GradeⅠhypertension group(P<0.05).In patients with H-type hypertension,serum Hcy level in TT genotype group was higher than those in CT genotype group and CC genotype group before and after folic acid treatment(P<0.01).After folic acid treatment,serum Hcy levels of the 3 genotypes were lower than those before treatment(P<0.05).Serum Hcy levels of TT genotype patients with H-type hypertension before and after folic acid treatment were higher than those of CT genotype patients and CC genotype patients(P<0.01).Conclusions The MTHFR gene C677T polymorphism is related to the severity of hypertension,and its determination has clinical value for individualized treatment efficacy of H-type hypertension.

关 键 词：亚甲基四氢叶酸还原酶 基因多态性 同型半胱氨酸 H型高血压 

分 类 号：Q554[生物学—生物化学]