老年慢性心力衰竭病人锰超氧化物歧化酶Ala-9Val基因多态性与预后的相关性研究

Correlation between manganese superoxide dismutase gene Ala-9Val polymorphisms and prognosis in the elderly patients with chronic heart failure

目的探讨陕西地区汉族人群中,锰超氧化物歧化酶(Mn-SOD)Ala-9Val基因多态性与老年慢性心力衰竭(CHF)病人预后的关系。方法选择2015年1月至2017年6月于我科住院治疗的老年CHF病人280例纳入CHF组,另随机选择同期在我院体检的健康志愿者100例为对照组。采用PCR-限制性片段长度多态性法检测Mn-SOD Ala-9Val基因多态性,比较2组Mn-SOD Ala-9Val基因多态性差异。将CHF组病人分为Val/Val亚组和(Ala/Ala+Ala/Val)亚组,统计比较2个亚组随访3年内心源性死亡发生率,再根据随访3年内是否发生心源性死亡进一步分为死亡亚组与存活亚组,统计分析CHF病人3年内心源性死亡的危险因素。结果2组Mn-SOD基因Ala-9Val位点基因型和等位基因分布频率差异均无统计学意义(P均>0.05)。Val/Val亚组和Ala/Val+Ala/Ala亚组3年死亡率分别为31.86%和15.69%,差异具有统计学意义(P=0.003)。多因素Logistic回归分析结果显示,携带Val/Val基因型是老年CHF病人3年内心源性死亡的独立危险因素(OR=1.759,95%CI1.151~2.687,P=0.003)。结论陕西地区汉族人群中,Mn-SOD Ala-9Val基因多态性与老年CHF病人预后相关。

Objective To investigate the correlation between manganese superoxide dismutase(Mn-SOD)gene Ala-9Val polymorphisms and the prognosis in the elderly patients with chronic heart failure(CHF)in the Han descent population of Shaanxi province.Methods A total of 280 elderly CHF patients hospitalized in our department from January 2015 to June 2017 were enrolled in this study as CHF group.Meanwhile,100 healthy volunteers who underwent physical examination in our hospital during the same period were randomly selected as the control group.Genotype was determined by polymerase chain reaction-restriction enzyme analysis for the Ala-9Val polymorphisms of Mn-SOD gene.The differences of genetic polymorphism between the two groups were compared.Accroding to genotype,CHF group was divided into Val/Val subgroup and Ala/Ala+Val/Ala subgroup,and the difference of 3-year cardiac mortality between two subgroups were observed and compared.Then,CHF group was divided into death subgroup and survival subgroup.The risk factors of the prognosis of CHF patients were statistically analyzed.Results There was no difference in genotype and allele of Mn-SOD gene Ala-9Val between CHF group and control group(all P>0.05).The 3-year cardiac mortality of Val/Val subgroup and Ala/Ala+Val/Ala subgroup was 31.86%and 15.69%,respectively(χ2=8.872,P=0.003).Multivariate Logistic regression analysis showed that Val/Val genotype was a risk factor of poor prognosis for elderly CHF patients(OR=1.759,95%CI1.151-2.687,P=0.003).Conclusions Polymorphism of the Mn-SOD gene Ala-9Val may be associated with the prognosis of elderly CHF patients in the Han descent population of Shaanxi province.