内皮型一氧化氮合酶基因多态性与高血压患者左室重构的关系

Association of Polymorphism of Endothelial Nitric Oxide Synthase Gene with Left Ventricular Hypertrophy in Hypertensive Patients

目的 探讨内皮型一氧化氮合酶 (eNOS)基因 2 7bp数目可变的串联重复序列 (VNTR )多态性与原发性高血压患者左室重构关系及其可能机制。方法 ①聚合酶链反应 (PCR)及琼脂糖凝胶电泳检测 2 60例EH患者的基因型 ,同时进行基因测序。②硝酸还原酶法测定血清一氧化氮代谢物 (NOx)水平 ,用放射免疫法测定内皮素 (ET)、血管紧张素Ⅱ (ATⅡ )的水平。③用彩色多普勒测算室间隔厚度、左室重量、左室重量指数。结果 ①aa +ab基因型携带者室间隔厚度、左室重量指数明显高于bb基因型携带者 (P <0 .0 5 )。②ab +ab基因型血清NOx、NOx/ET比明显低于bb基因型 (P <0 .0 5 )。③bb基因型ET、ATⅡ水平低于aa +ab基因型 ,但未达到统计学差异 (P >0 .0 5 )。结论 eNOS基因 2 7bpVNTR的a等位基因与原发性高血压患者左室肥厚相关 ,这可能与内皮NO的释放减少、ET和ATⅡ水平增加有关。

Objective To investigate the association of the polymorphism of endothelial nitric oxide synthase (eNOS) gene 27bp variable number of tandem repeats (VNTR) with left ventricular hypertrophy (LVH) in hypertensive patients and it's possible mechanism. Methods ①Genotypes of 260 patients were determined by polymerase chain reaction (PCR) and agarose gel electrophoresis and gene sequencing; ②Serum nitric oxide metabolite (NOx), Endothelin (ET) and Angiotensin II (ATⅡ) were measured by nitrate reductase and radioimmunoassay respectively; ③Intraventricular septem thickness (IVST), left ventricular mass (LVM), left ventricular mass index (LVMI) were measured. Results ①IVST and LVMI of aa+ab genotype was higher than bb genotype apparently ( P <0.05); ②The level of NOx and the rate of NOx/ET in ab+aa genotype were lower than bb genotype ( P <0.05); ③The level of ET and AT II of ab+aa genotype were higher than bb genotype, but there were no significance( P >0.05). Conclusion The polymorphism of eNOS gene 27bp VNTR is associated with LVH of hypertensive patients, which may be related to decrease of NO and increase of ET and AT II. [