脑卒中患者血管紧张素转换酶基因多态性与心率变异性的关联研究

目的　探讨脑卒中患者血管紧张素转换酶 (angiotensin- converting enzyme,ACE)基因多态性和心脏心率变异性的关系。方法　应用聚合酶链反应方法检测 4 3名正常人、4 6例脑梗塞患者、4 0例脑出血患者 ACE基因的插入 /缺失多态性 (insertion/deletion,I/D) ,并用心率变异性 (heart rate variability,HRV)分析方法观察其 HRV的时域、频域和混沌参数。结果　缺血性、出血性脑卒中患者的 ACE基因缺失型 (DD)及 D等位基因频率明显高于正常对照组 (P<0 .0 1) ,DD型患者的 HRV的参数值升高 ,即相邻心搏间期的均方根值、相邻心搏间期差大于 10 ms的心搏间期数占心搏间期总数的百分比、总功率谱、高功率谱、低频功率谱、混沌参数 ,明显高于 ACE基因插入型 (II)、ACE基因插入 /缺失混合型 (ID)患者 ,差异有显著性 (P<0 .0 5 )。结论　 HRV的相关参数和遗传相关 ,提示脑卒中患者有 ACE DD基因型的人 ,有脑源性心脏自主神经功能紊乱发生的危险性。

The relationship between angiotensin-converting enzyme gene polymorphism and heart rate variability in cerebral stroke

Objective To identify the relationship between angiotensin-converting enzyme(ACE) gene polymorphism and heart rate variability in cerebral stroke patients. Methods An insertion/deletion(I/D) polymorphism of the ACE gene was analyzed by polymerase chain reaction in 43 normal subjects, 46 patients with ischemic cerebral stroke, and 40 patients with brain hemorrhage; their heart rate variability(HRV) parameters such as time domain and power spectral component were analyzed. Results The frequency of DD genotype and the frequency of deletion alleles in cerebral stroke groups were significantly higher than those in control groups (P<0.01), and the measured components of HRV, including total power (TP), low frequency power (LF), high frequency power (HF), LF/HF, and choas, were higher in the patients with the ACE DD genotype when compared with those in the patients with the ACE II, ID genotypes; there was significant difference in effective rate (P<0.05). Conclusion The above related parameters of HRV were correlated with heritability, suggesting that the cerebral stroke patients with the ACE DD genotype are at high risk of cerebrogenic cardiac autonomic nerve function disturbances.