云南汉族原发性高血压左室重构与HLA-DQA1等位基因的相关研究

目的探讨云南汉族原发性高血压（EH）左室重构包括左室肥厚（LVH）及左室扩大（LVD）与HLA—DQA1等位基因的相关性。方法对超声心动图诊断的云南汉族中43例高血压合并LVH患者（EH—LVH＋组）与48例高血压非LVH患者（EH—LVH-组）、对16例高血压伴左室扩大患者（EH—LVD＋组）与75例高血压不伴左室扩大患者（EH—LVD-组）分别进行病例-对照研究，采用PCR—SSP技术对其进行HLA—DQA1等位基因分型。结果（1）EH—LVH＋组中DQA1＊0302频率明显高于EH-LVH-组（18．8％vs5．8％，χ^2=6．876，P〈0．01；RR=3．73）；EH-LVH＋组中DQA1＊0201频率明显低于EH—LVH-组（5．2％vs24．4％，χ^2=13．671，P〈0．01；RR=0．17）；（2）HLA—DQA1等位基因频率在EH-LVD＋组与EH—LVD-组的比较无统计学意义（P〉0．05）；（3）原发性高血压伴左室肥厚的易患因素是：病程、收缩压、DQA1＊0302。结论云南汉族HIA—DQA1等位基因可能与高血压病左室重构中的心肌肥厚有关而与心腔扩大无明显相关。DQA1＊0302可能是云南汉族EH-LVH的易感基因；DQA1＊0201可能是EH—LVH的保护基因。病程长、收缩压高是原发性高血压伴左室肥厚的易患因素。

The relationship between essential hypertension with left ventricular remodeling and HLA-DQA1 allele in Yunnan Hans

Objective To explore the relationship between the essential hypertension （EH） with left ventricular remolding including left ventricular hypertrophy （LVH） and left ventricular dilation （LVD） and polymorphism of HLA-DQA1 alleles in Yunnan Hans. Methods Cardiac remodeling of 91 hypertensive patients in Yunnan Hans was measured by echocardiography. The alleles of HLA-DQA1 of the hypertensive patents were determined by polymerase chain reaction sequence specific primers （PCR-SSP）. Results The frequency of DQA1 ＊ 0302 of the EH-LVH ＋ group was significantly higher than that of the EH-LVH-group（P 〈 0.01 ）. But the frequency of DQA1 ＊ 0201 of the EH-LVH ＋ group was significantly lower than that of the EH-LVH-group （P 〈 0.01 ）. There was no difference in the frequency of HLA-DQA1 between the EH-LVD ＋ group and the EH-LVD-group （P 〉 0.05）. The risk factors of EH with LVH are long course of hypertension, systolic blood pressure and DQA1 ＊ 0302. Conclusions HLA- DQA1 alleles is possibly related to the EH-LVH but not to the EH-LVD of left remodeling in Yunnan Hans. It is possible that the HLA- DQA1 ＊ 0302 is a susceptible gene of EH-LVH; HLA- DQA1 ＊ 0201 is a protective gene of EH-LVH. The risk factors of EH with LVH are long course of hypertension, high systolic blood pressure and DQA1 ＊ 0302.