老年高血压及冠心病患者载脂蛋白E基因与血管紧张素转换酶基因的多态性

Polymorphism of apolipoprotein E gene and angiotensin 1-converting enzyme in the elderly with hypertension and coronary heart disease

目的:探讨载脂蛋白E基因和血管紧张素转换酶基因多态性与老年人高血压、冠心病发病的关系,为其预后判定提供理论依据。方法:应用聚合酶链式反应-限制性片段长度多态的方法对1998-11/2001-11三明市第一医院老年病房住院的341例老年高血压并发冠心病患者及86例健康老人的载脂蛋白E基因和血管紧张素转换酶基因进行分型,并分析各等位基因及基因型与疾病的关联性。结果:①载脂蛋白E基因各等位基因频率分布在对照组和疾病组间均存在显著性差异,表现为ε2,ε4基因频率在疾病组中增高,ε3基因频率在疾病组中降低(Z=3.191～7.234,P<0.05)。②血管紧张素转换酶基因DD型频率在疾病组中显著性增多(Z=2.503,P<0.05),DI型频率在疾病组中显著性减少(Z=2.522,P<0.05)。③经关联性分析,载脂蛋白E与血管紧张素转换酶与高血压冠心病均相关联,表现为载脂蛋白E的ε2,ε4等位基因与之成正关联(OR=2.980和3.208,P均<0.05),ε3等位基因与疾病成负关联(OR=0.237,P<0.05);血管紧张素转换酶的DD基因型与疾病成正关联(OR=1.821,P<0.05),DI基因型与疾病成负关联(OR=0.491,P<0.05)。结论:载脂蛋白E基因的ε2,ε4等位基因可能构成了高血压冠心病的易患因素,ε3等位基因则对此起保护作用,为一级康复干预提供实验室数据。

AIM:To investigate the relations of the gene polymorphisms of apolipoprotein E(ApoE) and angiotensin 1-converting enzyme(ACE) with hypertension and coronary artery disease(CHD) in elderly patients,so as to provide theoretical evidence for the prognosis judgement. METHODS:Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) technique was used to detect the genotypes of ApoE gene and ACE gene in 341 elderly hypertensive inpatients with CHD(study group),who were hospitalized in the Sanming First People's Hospital between November 1998 and November 2001, and 86 healthy elderly controls(control group),and the association of each allele with the disease was analyzed. RESULTS:①There were significant differences in the allele frequency distribution of ApoE gene between the study group and control group,the gene frequencies of ε2 and ε4 were increased while that of ε3 frequency was decreased in the study group(Z=3.191 to 7.234,P< 0.05).②In ACE genotypes, DD frequency was significantly increased(Z=2.503,P< 0.05) and DI frequency was remarkably decreased(Z=2.522,P< 0.05) in the study group.③The correlation analysis showed that ApoE and ACE were associated with hypertensive CHD,ε2 and ε4 alleles were positively correlated with hypertensive CHD(OR=2.980,3.208,P< 0.05), while ε3 had negative correlation with it (OR=0.237,P< 0.05);DD of ACE genotype showed a positive correlation(OR=1.821,P< 0.05) and DI showed a negative correlation with the disease(OR=0.491,P< 0.05). CONCLUSION:The ε2 and ε4 alleles of ApoE gene may be the predisposing factors of hypertensive CHD,while ε3 has a protective effect on the disease.