高血压脑梗死患者血管紧张素转换酶基因多态性分析

Association between gene polymorphism of angiotensin-converting enzyme and hypertensive cerebral infarction

目的 探讨血管紧张素转换酶 (ACE)基因多态性与高血压脑梗死发病的关系。方法 采用聚合酶链反应技术 (PCR) ,对158名健康成人和50例原发性高血压、90例高血压脑梗死患者ACE基因插入/缺失 (I/D)多态性进行检测 ,并用非条件Logistic回归筛选出与高血压脑梗死发病相关的因素。 结果 DD基因型、D等位基因频率高血压脑梗死组高于正常对照组 (P<0.01)和高血压组 (P<0.05)。发病年龄在60岁以上者 ,DD基因型、D等位基因频率高血压脑梗死组高于高血压组和正常对照组 (P<0.05、P<0.01) ;而60岁以下起病者 ,DD基因型、D等位基因频率高血压脑梗死组则与高血压组、正常对照组无差别 (均P>0.05) ,而高血压组D等位基因频率高于正常对照组 (P<0.05)。ACEDD基因型是高血压脑梗死独立的危险因素 ,发现高血压时间是高血压脑梗死的保护因素。结论 ACEDD基因型携带者发生高血压脑梗死的危险性增高 ,早期发现及治疗高血压对降低高血压患者脑梗死发生有意义。

Objective To identify the association between gene polymorphism of angiotensin-converting enzyme (ACE) and hypertensive cerebral infarction. Methods ACE gene polymorphism was determined by polymerase chain reaction(PCR) in 158 normal controls, 50 cases of essential hypertension and 90 cases of essential hypertension with cerebral infarction. Variables, including sex, age, smoking, duration of finding hypertension, blood glucose, serum lipid profile, apoproteins, ACE genotype and gene I/D polymorphism, were analyzed with multivariate Logistic regression to determine the independent and significant risk factors for hypertensive cerebral infarction. Results Frequency of the DD genotype and D allele were significantly higher in hypertensive patients with cerebral infarction than in those without cerebral infarction (χ2=19.488?15.920, P<0.01) and normal controls (χ2=6.17?4.09,P<0.05). Both distributions in cerebral infarction patients with onset after age of 60 was significantly higher than those without cerebral infarction (χ2=5.380, P<0.05) and control group (χ2=14.746,P<0.01).There were no significant differences among three groups at age of 60 or below, but D allele was significantly higher in hypentensive patients than control group(χ2=4.080,P<0.05). Multivariate Logistic regression analysis showed that DD genotype was an independent risk factor for cerebral infarction in hypertensive patients.The odds ratio(95%CI) was 2.7987(1.2032～6.5095,P<0.05).Duration of finding hypertension was a protective factor for cerebral infarction in hypertensive patients, the odds ratio (95%CI) was 0.6828(0.4998～0.9329 ,P<0.01). Conclusion DD genotype increased risk of cerebral infarction in hypertensive patients. ACE gene I/D polymorphism analysis by PCR is conductive to early detection of hypertensive patients susceptible to cerebral infarction.