原发性高血压患者ACE2基因G8790A多态性与心房颤动的相关性研究

Relation of ACE2 gene G8790A polymorphism and atrialfibrillation in patients with primary hypertension

目的:探讨中国河南豫北地区原发性高血压人群血管紧张素转化酶2(ACE2)基因G8790A多态性与心房颤动(Af)的关系。方法:运用病例-对照法,选择953例原发性高血压患者,运用PCR-RFLP对其中475例伴Af(Af组)和478例窦性心律者(非Af组)的ACE2基因G8790A多态性进行基因分型及分析。结果:ACE2基因G8790A等位基因G在男性中的频率:Af组157例(72.0%),非Af组100例(59.5%),差异有统计学意义(P<0.05);在女性中的频率:Af组291例(56.6%),非Af组280例(45.2%),差异有统计学意义(P<0.05)。携带等位基因G的高血压男、女患者发生Af的危险性均增加(OR:1.82,95%CI:1.15～3.07;OR:1.99,95%CI:1.29～5.01,P<0.05)。基因型AA、AG和GG在Af组女性的频率分别为47例(18.3%)、130例(50.6%)和80例(31.1%),在非Af组分别为98例(31.6%)、136例(43.9%)、76例(24.5%),两组基因型分布差异有统计学意义(P<0.05)。与AA基因型相比,携带GG基因型的女性原发性高血压患者发生Af危险性增加(OR=2.05,95%CI:1.390～3.403),男性携带G等位基因和女性携带GG基因型的高血压并发Af患者左心房内径明显增大(P<0.05),女性携带GG基因型者左心室射血分数明显降低(P<0.05)。结论:ACE2基因G8790A多态性与原发性高血压患者Af的发生存在相关性,男女性携带G等位基因和女性携带GG基因型可能使原发性高血压发生Af的危险性增加。

Objective：To investigate the potential association of angiotensin-converting enzyme 2（ACE2） gene G8790A polymorphism with atrial fibrillation（Af） in primary hypertensive patients in Yubei district of Henan province. Method：A total of 953 patients with primary hypertension were recruited,among 475 with Af（Af group） and 478 with sinus rhythm（Non-Af group）.ACE2 8790G/A polymorphism was detected by PCR-RFLP. Result：The G allele frequencies of ACE2 gene in male was 157（72.0%） in Af group and 100（59.5%） in Non-Af group（P〈0.01）,while in femal was 291（56.6%） in Af group and 280（45.2%） in Non-Af group（P〈0.05）;The risk of Af increased in male and female patients who carried G allele than those carried A allele（male： OR： 1.82,95%CI： 1.15-3.07;female： OR： 1.99,95%CI： 1.29-5.01）.The frequencies of AA,AG and GG in female wre 47（18.3%）,130（50.6%） and 80（31.1%） in Af group,while 98（31.6%）,136（43.9%） and 76（24.5%） in Non-Af group（P〈0.05）.Compared with AA genotype,GG genotype increased the risk of Af in female patients with primary hypertension（OR=2.05,95%CI： 1.390-3.403）.G allele in male and GG genotype in female significantly increased left atrial diameter,and the latter decreased left ventricular ejection fractions in patients with Af. Conclusion：The development of Af in patients with primary hypertension may be associated with ACE2 genotypes,and polymorphism of ACE2 8790G/A may play a role in occurrence of Af in hypertensive patients.