不稳定型心绞痛患者血管紧张素基因多态性与同型半胱氨酸的相关性研究

Correlation between angiotensin gene polymorphism and homocysteine in patients with unstable angina pectoris

目的:分析与探讨冠心病不稳定型心绞痛(UA)患者血管紧张素转换酶(ACE)基因多态性与血清同型半胱氨酸(HCY)水平之间的关系。方法:收治老年病科住院患者96例作为试验组,对照组为同期健康志愿者96例。对比两组间血清HCY水平与基因Ⅰ/D多态性。并根据PCR产物电泳结果分Ⅱ型纯合子、ⅠD型杂合子、DD型纯合子3组。结果:试验组ACE基因的DD基因型频率高于对照组;相比于对照组患者,试验组的血清HCY水平明显上升;Logistic回归显示,冠心病风险增加和血清HCY水平的上升存在直接相关性。结论:ACE基因I/D多态性中DD及ID基因型是CHD的独立危险因素,随DD基因型频率的增加,冠心病风险加大;CHD患者血清HCY水平较正常人明显升高,其中UA患者升高更加显著。提示血清HCY水平与ACE位点的基因型均共同与冠心病,尤其是不稳定型心绞痛有良好的相关性。

Objective:To analyze and discuss the relationship between angiotensin-converting enzyme(ACE)gene polymorphism and coronary heart disease,unstable angina pectoris(UA)and serum homocysteine(HCY)level.Methods:96 cases of hospitalized patients in the department of geriatrics were treated as the experimental group,and the control group was 96 cases of healthy volunteers.The serum HCY level and geneⅠ/D polymorphism were compared between groups.According to the electrophoresis results of PCR products,they were divided into the 3 groups:typeⅡhomozygote,typeⅠD heterozygote and DD homozygote.Results:The DD genotype frequency of ACE gene in the experimental group was higher than that of the control group.Compared with the control group,the serum level of HCY in the experimental group was significantly increased.Logistic regression shows a direct correlation between increased risk of coronary heart disease and a rise in serum HCY levels.Conclusion:The DD and ID genotypes in the ACE gene I/D polymorphism are independent risk factors for CHD,the risk of coronary heart disease increases with the increase in the frequency of DD genotypes,the level of serum HCY in CHD patients was significantly higher than that of normal people,and the increase of UA patients was more significant.It is suggested that both the serum HCY level and the genotype of ACE loci are associated with coronary heart disease,especially unstable angina pectoris.