血管紧张素原基因T174M和血管紧张素转换酶基因I/D多态性与急性心肌梗死的相关性

目的探讨中国汉族人群血管紧张素转换酶和血管紧张素原基因型的分布及其与急性心肌梗死的关系。方法应用聚合酶链反应技术,对112例急性心肌梗死患者、128例非冠心病患者血管紧张素转换酶I/D多态性及血管紧张素原T174M多态性进行检测。结果血管紧张素转换酶基因型分布及等位基因频率在病例组及对照组间差异有显著性(P<0.01)。病例组和对照组血管紧张素原基因型及等位基因频率总体分布差异亦有显著性(P<0.05)。联合基因分析显示,急性心肌梗死组血管紧张素转换酶DD基因型 血管紧张素原174MM基因型频率显著高于对照组(P<0.01),具有该联合基因型者发生冠心病的风险比数比(OR=8.467)明显高于单独具有血管紧张素转换酶DD基因型(OR=2.558)或血管紧张素原174MM基因型(OR=6.176)者。结论血管紧张素原T174M基因多态性中M等位基因和血管紧张素转换酶I/D基因多态性基因中的D等位基因是中国汉族人群冠心病发病的危险因素之一。同时具有血管紧张素转换酶DD型及血管紧张素原174MM型发生冠心病的相对风险显著高于单基因血管紧张素转换酶DD型及单基因血管紧张素原174MM型。

Association of the Angiotensin Converting Enzyme I/D and Angiotensinogen T174M Gene Polymorphism with Acute Myocardial Infarction

Aim To evaluate the association between the molecular variants of rennin angiotensin system and the risk of acute myocardial infarction(AMI) in Chinese Han population. Methods Insert/deletion(I/D) of angiotensin converting enzyme(ACE) and angiotensinogen(AGT) T174M polymorphisms were determined by the means of polymerase chain reaction(PCR) in 112 AMI patients and 128 patients without AMI. Results The frequencies of DD genotype and D allele in patients with AMI were higher than those without AMI(P<0.01).The frequencies of MM genotype and M allele in patients with AMI were higher than those without AMI(P<0.05).In combined genotype analysis,the genotype of ACE DD AGT 174MM was significantly higher in patients with AMI than those without AMI(P<0.01).The odds ratio estimated by the combined analysis of the ACE DD and AGT 174MM genotypes(OR=8.467) was markedly increased compared with that estimated separately from the ACE DD(OR=2.558) or AGT 174MM(OR=6.176) genotype. Conclusion The study suggests that AGT 174M allele and ACE D allele should be a risk factor for AMI in Chinese Han population and combined analysis of the ACE DD and AGT 174MM genotype may enhance the predictability of AMI.