高血压左心室肥厚患者p22phox基因多态性与心房颤动的相关性研究

Relationship between p22phox gene polymorphisms and atrial fibrillation in patients with hypertension and left ventricular hypertrophy

目的探讨高血压左心室肥厚(LVH)患者p22phox基因C242T和-930A/G位点多态性与发生心房颤动(AF)的相关性。方法选择881例原发性高血压合并LVH患者,纳入其中128例合并心房颤动者作为AF组,在753例窦性心律患者中,根据年龄、性别、左室重量指数等临床资料与AF组进行1∶2配比,选择256例窦性心律者作为对照组。运用聚合酶链反应-限制性片段长度多态分析法检测p22phox基因C242T和-930A/G位点的多态性,比较两个位点的基因型及等位基因频率在两组间的分布差异。结果AF组p22phox基因C242T多态位点的TT和CT基因型以及T等位基因频率显著低于对照组(χ2=5.460,P=0.019;χ2=4.414,P=0.036)。多元logistic回归分析校正左房直径后,T等位基因携带者(TT+CT)发生房颤的风险约为CC型纯合子的0.5倍(OR=0.516,95%CI0.312～0.925,P=0.025)。p22phox基因-930A/G多态位点的基因型和等位基因频率在AF组与对照组间的分布无统计学差异。结论p22phox基因C242T位点的多态性与高血压LVH患者房颤的发生显著相关,T等位基因在其中发挥了保护性作用,而-930A/G多态与高血压LVH患者房颤的发生无关。

Objective To investigate the correlation between genetic variations of p22 phox gene（C242T and-930A/G）and the risk of atrial fibrillation（AF）in patients with hypertension and left ventricular hypertrophy（LVH）.Methods A total of 881 consecutive patients with hypertension and LVH were admitted to Fuzhou General Hospital of Nanjing Command with or without a history of AF were included in the present study.One hundred and twenty-eight patients with AF were assigned into AF group.The remaining two hundred and fifty-six patients without AF were assigned into control group.Patients in the two groups were matched at a ratio of 1∶2 in accordance to the clinical features,including gender,age and left ventricular mass index.The C242T and-930A/G polymorphisms of p22phox gene was detected by PCR-restriction fragment length polymorphism（RFLP）.The genotype at the two sites and the distribution of allele frequency in the two groups were compared.Results Both the genotype distributions and allele frequencies of p22phox C242T polymorphism were significantly different between AF and control groups,and the frequencies of TT＋CT genotypes and T allele were significantly lower in AF group than in control group（χ2=5.460,P=0.019;χ2=4.414,P=0.036,respectively）.With correction of left atrial dimension by multiple logistic regression,the T allele carriers（TC＋TT）showed an approximately 0.5-fold risk of developing AF compared with CC homozygote（OR=0.516,95% CI：0.312～0.925;adjusted P=0.025）.No statistic difference existed in both genotype distributions and allele frequencies of the p22phox-930A/G polymorphism between the two groups.Conclusions The C242T polymorphism of the p22 phox gene is significantly associated with the risk of developing AF in patients with hypertension and LVH.The T allele may have a protective effect against AF.No association is found between-930A/G polymorphism and development of AF in the patients with hypertension and LVH.