血管紧张素转换酶和血管紧张素原基因多态性与冠心病的关系

Relationship between coronary heart disease and polymorphism of angiotension converting enzyme and angiotensiongen genes

目的探讨血管紧张素转换酶（ACE）插入／缺失（I／D）多态性和血管紧张素原（AGT）M235T基因多态性与冠心病（CHD）的关系。方法应用多聚酶链反应结合限制性内切酶法（PCR—RFLP）对110例冠心病患者、62例冠状动脉造影正常者以及18名门诊常规体检无冠心病史者基因多态性进行分析。结果①CHD组ACE基因DD基因型及D等位基因频率明显高于健康对照组（分别为43．6％、60．5％比26．3％、44．4％），差异有统计学意义‘P〈0．05）。CHD组AGT基因TT基因型及T等位基因频率明显高于对照组（分别为66．4％、78．6％比42．5％、60．6％），差异有统计学意义（尸〈0．05）。②男性CHD组ACE基因DD基因型和D等位基因频率以及AGT基因TT基因型和T等位基因频率均显著高于对照组（均P〈O．05）。女性CHD组ACE基因DD基因型和D等位基因频率以及AGT基因‘rr基因型和T等位基因频率与对照组比较差异无统计学意义（P〉0．05）。③联合分析ACEDD型及AGTTr型罹患冠心病的相对风险，其比数~L（OR）为4．904，高于单基因ACEDD型（2．175）及AGTTT型（2．669）。结论ACE基因I／D多态性及AGT基因M235T多态性与CHD有显著相关性，同时具有ACEDD型及AGT TT型发生冠心病的相对风险显著高于单基因ACEDD型及单基因AGT‘丌型。性别也可作为冠心病的危险因素。

Objective To study the association between coronary heart disease and polymorphism of an- giotension converting enzyme gene insertion/deletion （I/D） and angiotensiongen gene M235T. Methods Polymerase chain reaction combined with restriction enzyme digestion （PCR-RFLP） was used to analyse the gene polymorphism in 110 patients with CHD identified by coronarty angiography and 80 control subjects that was composed of 62 cas- es with normal result of coronary angiography and 18 healthy subjects without clinical evidence of CHD. Results （1）The frequency of DD genetype and D allele was significiently higher in CHD group than that in control group （43.6% ,60.5%vs26.3% ,44.4% respectively） （P〈0.05）. The frequency of 3~F genetype and T allele was significiently higher in CHD group than that in control group （66.4% ,78.6% vs 42.5% ,60.6% respectively） （P〈0.05）. （2）In men, the frequencies of DD genetype ,D allele and TY genetype,T allele are significiently higher in CHD group than that in control group （P〈0.05）.In women, the frequencies of DD genetype,D allele and TT genetype,T allele were significant difference between CHD group and control group （P〉0.05）. （3）The odds ratio （OR） estimated by combined analysis with ACE-DD and AGT-TI＂ genotypes （4.904） were markedly increased compared with that esti- mated alone from either ACE-DD （2.175） or AGT-TI＂ （2.669） genotype. Conclusion There is a strong correlation between coronary heart disease and polymorphism of angiotension converting enzyme gene insertion/deletion（I/D） and angiotensiongen gene M235T, and combined analysis of the ACE-DD and AGT-TT genotype may enhance the pre- dictability of CHD. Sex may be a risk factor of CHD.