ACE、ApoE基因多态性与高血压患者冠状动脉狭窄程度的相关性研究

Correlation between ACE and ApoE gene polymorphisms and coronary artery stenosis in patients with hypertension

目的探讨血管紧张素转换酶(angiotensin converting enzyme,ACE)、载脂蛋白E(apolipoprotein E,ApoE)基因多态性与高血压患者冠状动脉狭窄程度的相关性。方法选取2019年1月至2022年2月浙江省中医院收治的180例高血压患者作为研究对象,根据其是否患有冠心病(coronary heart disease,CHD)分为对照组(n=85)和CHD组(n=95),同时根据冠状动脉造影结果将CHD组分为单支病变组(n=25)及多支病变组(n=70),统计并比较单支病变组与多支病变组ACE基因型、ApoE基因型与等位基因频率的分布,不同冠状动脉病变程度组别ACE基因多态性、Apo E基因多态性分布情况。结果多支病变组ACE DD基因型频率和ACE D等位基因的频率均显著高于单支病变组(P<0.05);多支病变组ACEⅡ和ACE ID基因型频率均显著低于ACE DD基因型(P<0.05);多支病变组ACE D等位基因频率显著高于ACEⅠ等位基因(P<0.05)。多支病变组ApoE4等位基因频率显著高于单支病变组(P<0.05);两组的ApoE2/E2、ApoE2/E3、ApoE2/E4、ApoE3/E4及ApoE4/E4基因型频率均显著低于同组ApoE3/E3基因型(P<0.05);两组的ApoE2、Apo E4等位基因频率均显著低于同组Apo E3等位基因(P<0.05)。多支病变组ACE DD基因型频率和ACE D等位基因的频率均显著高于单支病变组(P<0.05);多支病变组ACEⅡ和ACE ID基因型频率均显著低于ACE DD基因型(P<0.05);多支病变组ACED等位基因频率显著高于ACEⅠ等位基因(P<0.05)。3组不同冠状动脉病变程度组的ApoE2/E2、ApoE2/E3、ApoE2/E4、ApoE3/E4、ApoE4/E4的基因型频率均显著低于ApoE3/E3基因型(P<0.05)。结论ACE、Apo E基因多态性与高血压患者冠状动脉病变范围及病变程度密切相关。

Objective To investigate the correlation between angiotensin-converting enzyme(ACE)and apolipoprotein E(ApoE)gene polymorphisms and the degree of coronary stenosis in patients with hypertension.Methods A total of 180 hypertensive patients admitted to Zhejiang Provincial Hospital of Traditional Chinese Medicine from January 2019 to February 2022 were selected and divided into the control group(n=85)and the CHD group(n=95)according to whether they had coronary heart disease(CHD).The distribution of ACE genotype,ApoE genotype and allele frequency in coronary single-vessel group(n=25)and multi-vessel disease group(n=70),distribution of ACE gene polymorphisms and ApoE gene polymorphisms in groups with different degrees of coronary artery disease were counted and compared.Results The frequency of ACE DD genotype and ACE D allele in the multi-vessel group were significantly higher than those in the single-vessel group(P<0.05).The frequency of ACEⅡand ACE ID genotypes in the multi-vessel group was significantly lower than that of ACE DD genotype(P<0.05).The frequency of ACE D allele was significantly higher than that of ACEⅠallele(P<0.05)in the multi-vessel group.The frequency of ApoE4 allele in the multi-vessel group was significantly higher than that in the single-vessel group(P<0.05).The frequencies of ApoE2/E2,ApoE2/E3,ApoE2/E4,ApoE3/E4 and ApoE4/E4 genotypes in the two groups were significantly lower than those in the same group(P<0.05).The frequencies of ApoE2 and ApoE4 alleles in both groups were significantly lower than those in the same group(P<0.05).The frequency of ACE DD genotype and ACE D allele in the multi-vessel group were significantly higher than those in the single-vessel group(P<0.05).The frequency of ACEⅡand ACE ID genotypes in the multi-vessel group was significantly lower than that of ACE DD genotype(P<0.05).The frequency of ACE D allele was significantly higher than that of ACEⅠallele(P<0.05)in the multi-vessel group.The genotype frequencies of ApoE2/E2,ApoE2/E3,ApoE2/E4,ApoE3/E4 and ApoE4/E4 in the three groups with different coronary artery vessel degrees were significantly lower than those of ApoE3/E3 genotype(P<0.05).Conclusion ACE and ApoE gene polymorphisms are closely related to the extent and severity of coronary artery vessel in patients with hypertension.