MTHFR基因多态性与中年男性冠状动脉病变程度的相关研究

Association of MTHFR Gene Polymorphism with Coronary Artery Lesions in Middle-aged Men

目的探讨四氢叶酸还原酶C677T基因多态性与中年男性冠状动脉病变程度。方法选择2015年1月~2016年10月经冠脉造影确诊的128例山东沿海地区汉族中年男性冠心病患者(冠脉狭窄>50%),其中急性心肌梗死36例,按照国际心脏病学会和WHO冠心病诊断标准将128例冠心病患者分为急性冠脉综合征(ACS)组67例和稳定性心绞痛(SAP)组61例,并选110例冠脉正常者作为对照组。通过循环酶法测定血浆同型半胱氨酸浓度和PCR荧光法检测MTHER C677T基因型,观察血浆同型半胱氨酸浓度和MTHFRC677T基因型分布与冠脉病变的关系。结果冠心病组血浆同型半胱氨酸水平明显高于对照组,差异有统计学意义(P<0.01),ACS组明显高于SAP组,差异有统计学意义(P<0.01)。冠状动脉三支病变组血浆同型半胱氨酸水平明显高于单支病变组,差异有统计学意义(P<0.01),且高于双支病变组,差异有统计学意义(P<0.05)。另外,双支病变组高于单支病变组,差异有统计学意义(P<0.05)。冠心病组TT基因型、T等位基因频率明显高于对照组,差异有统计学意义(P<0.01);CT基因型高于对照组,差异有统计学意义(P<0.05)。ACS组TT基因型高于SAP组,差异有统计学意义(P<0.05),T等位基因频率明显高于SAP组,差异有统计学意义(P<0.01)。冠状动脉三支病变组TT基因型、T等位基因频率高于单支病变组,差异有统计学意义(P均<0.05)。结论 MTHERC677T基因多态性及血浆同型半胱氨酸浓度参与山东沿海地区汉族中年男性冠状动脉粥样硬化病变的发生发展,且与冠脉病变严重程度有关。

Objective To investigate the polymorphism of tetrahydrofolate reductase gene C677T and the degree of coronary artery disease in middle-aged men.Methods From January 2015 to October 2016,128 middle-aged male CHD patients(coronary artery stenosis>50%)diagnosed by coronary angiography in Shandong coastal area were selected.Among them,36 cases were acute myocardial infarction.According to the International Society of Cardiology WHO diagnostic criteria for coronary heart disease in 128 patients with coronary heart disease were divided into acute coronary syndrome(ACS)group of 67 patients with stable angina pectoris(SAP)group of 61 cases,and selected 110 cases of normal coronary artery as a control group.The levels of homocysteine in plasma and the fluorescence intensity of PCR were detected by cyclic enzymatic method to detect the MTHF C677T genotype.The plasma concentrations of homocysteine and the distribution of MTHFRC677T genotypes were also determined.Results The plasma homocysteine level in CHD group was significantly higher than that in control group,The difference was statistically significant(P<0.01).The level of plasma homocysteine in ACS group was significantly higher than that in SAP group,the difference was statistically significant(P<0.01).Plasma homocysteine level in the three coronary artery lesions group was significantly higher than that in the single vessel disease group,the difference was statistically significant(P<0.01),and higher than the double-vessel disease group,the difference was statistically significant(P<0.05).In addition,the double-vessel lesion group was higher than the single vessel lesion group,the difference was statistically significant(P<0.05).The frequencies of TT genotype and T allele in CHD group were significantly higher than those in control group,the difference was statistically significant(P<0.01).The genotype of CT was higher than that of the control group,the difference was statistically significant(P<0.05).The TT genotype in ACS group was higher than that in SAP group,the difference was statistically significant(P<0.05),T allele frequency was significantly higher than SAP group,the difference was statistically significant(P<0.01).The TT genotype and T allele frequency in the three coronary artery lesions group were higher than those in the single vessel disease group,the difference was statistically significant(P<0.05).Conclusion MTHERC677T gene polymorphism and plasma homocysteine concentration are involved in the development of coronary atherosclerosis in middle-aged Han men in Shandong coastal areas,and are related to the severity of coronary artery disease.