ACE2基因多态性与高血压合并缺血性脑卒中临床危险因素的相关性

Correlation of angiotensin-converting enzyme 2 gene polymorphisms to essential hypertension and ischemic stroke

目的研究血管紧张素转换酶2(ACE2)基因多态性与中国南方高血压合并缺血性脑卒中患者的临床危险因素的相关性。方法采用聚合酶链反应和限制性片段长度多态性(PCR-RFLP)的方法,检测139例原发性高血压合并缺血性脑卒中患者的ACE2基因型,同时测定脉压、高敏C反应蛋白、颈动脉内膜中层厚度、高密度脂蛋白及血尿酸水平,分析ACE2基因与原发性高血压患者中缺血性脑卒中发病临床危险因素的相关性。结果高敏C反应蛋白、脉压、颈动脉内膜中层厚度、尿酸与原发性高血压患者脑卒中的发生呈正相关,男性A基因型者其脉压、高敏C反应蛋白、颈动脉内膜中层厚度、高密度脂蛋白水平高于G基因型者,差异有统计学意义(P<0.05);女性不同基因型者其脉压、高敏C反应蛋白、颈动脉内膜中层厚度、高密度脂蛋白水平不同,其中AA型者较高,差异有统计学意义(P<0.05)。在不同基因型患者血尿酸水平不同,差异无统计学意义(P>0.05)。结论原发性高血压合并缺血性脑卒中患者中,携带A/AA基因者其临床危险因素水平较高,具有再发卒中易感性。

Objective To study the relationship between angiotensin-converting enzyme 2 （ACE2） gene polymorphisms and the risk factor for essential hypertension （EH） with concurrent ischemic stroke in southern Chinese population. Methods The G9570A polymorphism in ACE2 gene were detected in 139 patients with EH and stroke using polymerase chain reaction-restriction fragment length polymorphism. Detailed clinical and biochemistrical data of the patients, including the pulse pressure, high sensitivity C-reactive protein （hsCRP）, intima-media thickness （IMT）, high-density lipoprotein cholesterol （HDL-C） and uric acid levels, were collected to study the relationship between ACE2 gene and the risk factor of EH and stroke. Results The levels of hsCRP （OR=1.022）, uric acid （OR=1.224）, IMT and pulse pressure was positively correlated to the incidence of EH and stroke. The pulse pressure, hsCRP, IMT, and HDL-C levels in male stroke patients carrying A allele was significantly higher than those in patients carrying G allele （P〈0.05）. In female stroke patients, the pulse pressure, hsCRP, IMT, and HDL-C levels were also significantly different with regard to the genotype of ACE2 gene （P〈0.05）. Conclusion The patients with EH and ischemic stroke carrying the A/AA allele of ACE2 gene have higher risks than those carrying other allele, and can be also more vulnerable to stroke recurrence.