MTHFR C677T基因多态性与老年心力衰竭患者心室重构的相关性

MTHFR C677T gene polymorphism and ventricular remodeling in elderly patients with heart failure

目的探讨MTHFR C677T基因的多态性分布,并分析与老年心力衰竭(HF)患者心室重构的相关性。方法入选诊断为老年HF患者98例(HF组),同期查体健康者40例为对照组。所有入选对象利用直接基因测序方法检测MTHFR C677T基因多态性,同时检测血浆同型半胱氨酸(Hcy)、脑钠肽(NT-pro BNP)水平。测量左心室舒张末内径(LVDd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)及测算左心室射血分数(LVEF),计算左心室质量指数(LVMI)。结果 HF组TT基因型频率和T等位基因频率明显高于对照组(P<0.05);HF组Hcy、LVMI、NTpro BNP均高于对照组,LVEF低于对照组(P<0.05);不同MTHFR C677T基因型者其血浆Hcy水平差异有统计学意义(P<0.05)。HF组伴左心室肥厚组,TT基因型频率及T等位基因频率高于HF组不伴左心室肥厚组。HF组TT基因型患者LVMI高于CT及CC基因型患者,而LVEF则低于CT及CC基因型患者。结论MTHFR C677T基因型与老年HF患者心室重构相关,TT基因型及T等位基因的老年HF患者发生心室重构的可能性大。

Objective To investigate the distribution of MTHFR C677 Tgenotypes on the subjects,and analyze its relationship to the ventricular remodeling in elderly patients with heart failure（HF）.Methods The study involved98 patients with HF as HF group,40 health people from body check as normal control group.MTHFR C677 Tgene polymorphism was detected by PCR-direct sequencing method.Meanwhile,plasma total homocysteine（Hcy）and brain natriuretic peptide（BNP）were measured.Left ventricular remodeling was evaluated by calculating the left ventricular end-diastolic diameter（LVDd）,left ventricular posterior wall thickness（LVPWT）,interventricular septal thickness（IVST）and left ventricular ejection fraction（LVEF）,left ventricular mass index（LVMI）of the subjects in two groups.Results Compared with those of control group,the genotype TT and allele T frequencies of C677 Tin MTHFR gene in HF group were significantly higher（P〈0.05）.Hcy,LVMI and NT-pro BNP in HF group were higher than those in control group（P〈0.05）.In HF group,LVMI was the highest,while LVEF was the lowest in TT genotype among three genotypes（P〈0.05）.The frequencies of genotype TT and allele T in HF group with left ventricular hypertrophy（LVH）group were higher than those in HF without LVH group（P〈0.05）.Conclusion The MTHFR genotypes have correlation with the ventricular remodeling in elderly HF patients,and the patients with TT genotype or T allele are easier to develop into LVH.