家族性高血压患者并发冠心病的风险因素分析

The Analysis on the Risk Factors for Familial Hypertension Patients with Coronary Heart Disease

目的调查家族性高血压患者并发冠心病的风险因素。方法 185例家族性高血压病人分为91例未并发冠心病组,94例高血压并发冠心病组,135例体检人群作为对照组,进行对比研究。内皮型一氧化氮合酶(eNOS)基因894G→T位点多态性采用聚合酶链反应—限制性酶切片段长度多态性(PCR-RFLP)技术。血清NOx(-NO2-、NO3-)水平通过显色法测定。全自动生化分析仪检测血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、尿素氮、肌酐水平。各检测结果通过Logistic回归分析筛选高风险因素。结果对照组、高血压组、高血压并发冠心病组中T等位基因频率依次升高,三组间差异有统计学意义(χ2=13.32,P=0.001 3),但高血压并发冠心病组与高血压组差别不显著,而在男性人群中,两者T等位基因频率差异有统计学意义(χ2=7.84,P=0.005)。血清NOx-检测显示对照组、高血压组、高血压并发冠心病组依次为(50.5±28.7)、(62.5±30.1)、(105.0±31.2)μmol/L,三组间差异有统计学意义(F=96.297,P=0.000)。Logistic回归分析性别(P=0.036)、血清NOx(-P=0.017)、三酰甘油(P=0.018)、肌酐(P=0.046)、894T(P=0.017)被选入Logistic回归方程。结论性别、血清、三酰甘油、肌酐、NOx-、eNOS基因第7外显子894T等位基因均属高血压并发冠心病的风险因素。

Objective To investigate the risk factors for familial essential hypertension patients complicated coronary heart disease. Methods A case control study was conducted in 185 familiar hypertension patients （including 94 patients with coronary heart disease and 91 patients without coronary heart disease） and 135 controls in health examinations. Genotypes of 894G→T polymorphisms of endothelial nitric oxide synthase （eNOS） were detected by the restrict fragment length polymorphism method after polymerase chain reaction （PCR-RFLP）. Serum NOn-（NO2-,NO3-）level was assayed by colorimetrie method. The automatic biochemical analyzer was used to detect levels of FPG, TG, TC, HDL-C, BUN and Cr. Logistic analysis was performed to screen high risk factors. Results The frequencies of allele T in control group, hypertension group, hypertension with CHD group increased gradually, the difference among the three groups was significant （X^2=13.32, P=0.001 3）. But the difference between the hypertension group and hypertension with CHD group had no significance. In contrast, the difference of the allele T frequencies in male between the hypertension group and hypertension with CHD group was significant （X^2=7.84, P=0.O05）. The serum NOx- of the three groups were （50.5±28.7） μmol/L, （62.5±30.1）μmol/L, （105.0±31.2）μmol/L; the difference among the three groups was significant（F=96.297, P=0.000）. Logistic analysis showed that the sex （P=0.036）, serum NO,- （P=0.017）, TG （P=0.018）, Cr （P=0.046）, 894T allele （P=0.017） were selected into Logistic regression equation. Conclusion The sex, serum TG, Cr, NOx- level and 894T allele of eNOS gene may be predisposal faetors for complieating CHD in familiar hypertension patients.