PEAR1、ApoE基因多态性与AMI患者易感性及临床特征的相关性分析

Correlation of PEAR1 and ApoE gene polymorphisms with susceptibility and clinical characteristics of patients with AMI

目的:探讨血小板内皮聚集受体-1(PEAR1)、载脂蛋白E(ApoE)基因多态性与急性心肌梗死(AMI)患者易感性及临床特征的相关性。方法:选取2019年1月—2021年2月心内科收治的AMI患者183例(病例组),选取无AMI病史的中老年志愿者92名(对照组)。采用实时荧光PCR法检测PEAR1和ApoE基因多态性。收集患者性别、年龄、肥胖、吸烟史、高血压、糖尿病、高脂血症、高同型半胱氨酸(Hcy)血症、冠心病家族史等临床资料。比较两组的临床资料以及PEAR1和ApoE基因型的频率分布,分析PEAR1和ApoE基因型分布与性别、年龄、肥胖、吸烟史、高血压、糖尿病、高脂血症、高同型半胱氨酸(Hcy)血症、冠心病家族史的相关性。结果:与对照组相比,病例组肥胖、吸烟史、高血压、糖尿病、高脂血症、高Hcy血症的比例升高(χ^(2)=7.857,P=0.005;χ^(2)=4.787,P=0.029;χ^(2)=34.790,P<0.001;χ^(2)=12.089,P=0.001;χ^(2)=13.355,P<0.001;χ^(2)=11.911,P=0.001)。与对照组相比,病例组GG基因型频率降低,AA基因型频率升高(χ^(2)=13.673,P=0.001)。与对照组相比,病例组G等位基因频率降低,A等位基因频率升高(χ^(2)=13.560,P<0.001)。与对照组相比,病例组ε3/ε3基因型频率降低,ε2/ε2、ε2/ε3、ε3/ε4、ε4/ε4基因型频率升高(χ^(2)=33.003,P<0.001)。与对照组相比,病例组ε3等位基因频率降低,ε2、ε4等位基因频率升高(χ^(2)=36.673,P<0.001)。PEAR1和ApoE基因型与性别、年龄、肥胖、吸烟史、高血压、糖尿病、高Hcy血症、冠心病家族史均无关联(均P>0.05)。ApoE基因型与高脂血症有关联,ε3/ε3基因型患者中高脂血症的比例低于ε2/ε4、ε2/ε2、ε2/ε3、ε3/ε4、ε4/ε4基因型患者(χ^(2)=24.571,P<0.001)。结论:PEAR1、ApoE基因多态性与AMI易感性有一定关联。

Objective:To investigate the correlation of platelet endothelial aggregation receptor-1(PEAR1)and apolipoprotein E(ApoE)gene polymorphisms with susceptibility and clinical characteristics of patients with acute myocardial infarction(AMI).Methods:This study included 183 patients with AMI(case group)admitted to the Department of Cardiology from January 2019 to February 2021,and 92 middle-aged and elderly volunteers without AMI history(control group)were selected.Real-time fluorescent PCR method was used to detect PEAR1 and ApoE gene polymorphisms.The patients′clinical data,including gender,age,obesity,smoking history,hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia and family history of coronary heart disease were collected.The clinical data,frequency distribution of PEAR1 and ApoE genotypes were compared between the two groups.The correlation of PEAR1 and ApoE genotype distribution with gender,age,obesity,smoking history,hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia and family history of coronary heart disease was analyzed.Results:Compared with the control group,the proportions of patients with obesity,smoking history,hypertension,diabetes,hyperlipidemia,and hyperhomocysteinemia were increased in the case group(χ^(2)=7.857,P=0.005;χ^(2)=4.787,P=0.029;χ^(2)=34.790,P<0.001;χ^(2)=12.089,P=0.001;χ^(2)=13.355,P<0.001;χ^(2)=11.911,P=0.001).Compared with the control group,GG genotype frequency was decreased,and AA genotype frequency was increased in the case group(χ^(2)=13.673,P=0.001).Compared with the control group,G allele frequency was decreased,and A allele frequency was increased in the case group(χ^(2)=13.560,P<0.001).Compared with the control group,ε3/ε3 genotype frequency was decreased,whileε2/ε2,ε2/ε3,ε3/ε4 andε4/ε4 genotype frequencies were increased in the case group(χ^(2)=33.003,P<0.001).Compared with the control group,ε3 allele frequency was decreased,whileε2 andε4 allele frequencies were increased in the case group(χ^(2)=36.673,P<0.001).PEAR1 and ApoE genotypes were not associated with gender,age,obesity,smoking history,hypertension,diabetes,hyperhomocysteinemia,and family history of coronary heart disease(all P<0.05).ApoE genotype was associated with hyperlipidemia.The proportion of hyperlipidemia was lower in patients carryingε3/ε3 genotype than in those carryingε2/ε4,ε2/ε2,ε2/ε3,ε3/ε4,andε4/ε4 genotypes(χ^(2)=24.571,P<0.001).Conclusion:PEAR1 and ApoE gene polymorphisms are associated with the susceptibility to AMI.