亚甲基四氢叶酸还原酶基因多态性与青年原发性高血压患者冠状动脉病变的关系

Relation of methyleneteyrahydrofolate reductase gene polymorphisms to coronary artery lesion in youth patients with hypertension

目的:探讨亚甲基四氢叶酸还原酶(MTHFR)基因多态性与青年原发性高血压(EH)患者冠状动脉 (冠脉)病变的关系。方法:利用分子灯塔技术检测79例青年EH患者的MTHFR基因型分布,冠脉造影了解冠脉病变情况,以冠脉造影阳性为Ⅰ组,冠脉造影阴性为Ⅱ组,分析年龄、病程、收缩压、舒张压、血糖、胆固醇、三酰甘油、吸烟史、饮酒史及MTHFR基因型在2组中的差别,以Logistic回归分析以上各因素与EH患者冠脉病变的相关性。结果:79例EH患者有25例冠脉造影结果异常(其中单支病变3例,双支病变8例,3支病变14例), 冠脉造影正常54例。基因型检测结果示TT 32(40．51％)、CT 34(43．04％)、CC 13(16．46％)符合Hardy-Weinbery定律。单因素分析Ⅰ组病程较Ⅱ组更长(P<0．05),Ⅰ组的TT基因型频率及T等位基因频率均高于Ⅱ组 (P<0．05),多因素Logistic回归分析也显示只有病程(OR=1．88,95％CI 1．28-2．77,P<0．01)和TT基因型(OR=4．37,95％CI 1．02-18．62,P<0．05)是青年EH患者发生冠脉病变的危险因素。结论:未经系统治疗的EH患者病程越长越易罹患冠心病,MTHFR基因多态性可能是青年EH患者发生冠脉病变的重要遗传学因素。

Objective： To study the correlation between methyleneteyrahydrofolate reductase gene polymorphisms and coronary heart disease （or abnormal coronary angiographical results） in young patients with hypertension. Method：Seventy-nine objects were separated into two groups by angiographical results（group Ⅰ abnormal vs group Ⅱ normal）. The genotypes were determined with polymerase chain reaction and molecular beacon technique. Result：The frequency of the MTHFR TT genotype（60%） and T allele（74% ） in the group I is significantly higher than that in the group Ⅱ （ P 〈0.05）. The duration of high blood pressure in the group I is longer than that in the groupⅡ （P 〈0.01）. Logistic analysis showed that the course of disease （OR 1.88 95% CI 1.28-2.77） and MTHFR TT genotypes （ OR 4.37 95% CI 1.02-18.62） were related to the occurrence of CHD in young patients with hypertension. Conclusion：The longer the duration of high blood pressure is, the higher the probability of the lesion of coronary artery is in young patients with hypertension. The polymorphisms of Methyleneteyrahydrofolate reductase gene was probably an important genetic factor for coronary artery disease in young patients with hypertension.