血管紧张素转换酶基因I/D多态性及其血清活性与冠心病的关系

I/D Genetic Polymorphism of the Plasminogen Angiotensin Convertion Enzyme Gene is Associated With Plasma Activity and the Risk of Coronary Artery Disease

目的 :从分子遗传水平探讨血管紧张素转换酶与冠心病的关系及其对冠状动脉病变程度的预测价值。方法 :3 45例患者包括对照患者 95例、心绞痛患者 10 0例及陈旧性心肌梗死患者 15 0例 ,通过两次聚合酶链反应确定血管紧张素转换酶基因型 ,并测定血清血管紧张素转换酶水平。为分析血管紧张素转换酶基因型与冠心病、心肌梗死的相关性 ,将心绞痛患者与陈旧性心肌梗死患者合称冠心病患者 ,对照患者与心绞痛患者合称非心肌梗死患者。结果 :血管紧张素转换酶活性在对照患者、心绞痛患者及心肌梗死患者间无统计学差异。血管紧张素转换酶基因DD、DI和II型的血清血管紧张素转换酶活性有显著性差异 ,经SpearmanRankCorrelation分析 ,血管紧张素转换酶活性与D等位基因数目存在等级相关 ,相关系数 0 2 2 5 ,P <0 0 0 1。血管紧张素转换酶基因型分布在对照患者与冠心病患者、心肌梗死患者与非心肌梗死患者间无显著性差异 ,然而经Logistic回归分析发现 ,在排除其他因素影响下血管紧张素转换酶基因DD型与II型相比 ,对冠心病及心肌梗死的危险性明显增加 ,调整后的OR值分别为 2 2 9及 1 68(P <0 0 5 ) ,提示血管紧张素转换酶基因DD型是冠心病、心肌梗死发生的危险因素。

Objective: To assess whether the common polymorphic allele(D) of the angiotensin convertion enzyme(ACE) gene is associated with coronary artery disease(CAD) or myocardial infarction(MI) and the extent of the coronary atherosclerosis Methods: Blood was drawn and DNA extracted in 345 patients from Fu Wai Hospital Among them 295 patients had undergone coronary angiography The D and I alleles of ACE were amplified using common primer and I specific primer Of the 345 patients, 95 had no CAD and MI (control group), 100 had angina pectoris (AP), and the other 145 had a history of MI Results: In this population, a strong correlation was observed between the ACE gene polymorphism and ACE activiti es. The ACE plasma activities were not significantly different among the control group, the AP group and the MI group Although there was no significant difference in the genotype distribution of ACE polymorphism in the three groups, in Logistic regression analysis, the ACE gene I/D polymorphism was significant correlated with CAD and MI Neither ACE polymorphism nor the plasma ACE activity was associated with the extent of the coronary atherosclerosis Conclusion: There is a strong correlation between the ACE genotype and activity The ACE gene polymorphism is correlated with CAD and MI But the ACE plasma activity and I/D genetic polymorphism were not associated with the extent of the coronary atherosclerosis