N-乙酰化转移酶2基因多态性与抗结核药物所致肝损伤的相关性

目的 探讨N-乙酰化转移酶2(NAT2)基因多态性与抗结核药致肝损伤(ADIH)的相关性.方法 以抗结核治疗3个月内出现肝损伤的106例结核患者为病例组,未出现肝损伤的106例结核患者为配对对照.采用1:1匹配的病例对照研究和聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)技术,检测106对结核患者的NAT2基因481C/T、590G/A、857G/A位点多态性情况,并对主要环境影响因素和基因型进行单因素和多因素条件Logistic回归分析.结果 病例组NAT2基因的481C/T、590G/A、857G/A位点的T、A、A等位基因频率分别为7.5%、28.8%、17.9%,对照组分别为6.6%、18.9%、17.5%.病例组NAT2慢速乙酰化型的频率明显高于对照组,粗OR值为2.250(95%CI为1.140～4.441).对文化程度、职业、体质指数(BMI)、吸烟、饮酒和结核类型6个可疑危险因素进行了单因素分析,仅低BMI和饮酒为ADIH发生的危险因素.在多因素分析中调整BMI、饮酒两个因素后,NAT2乙酰化程度仍与ADIH的发生显著相关,调整OR值为2.246(95%CI为1.086～4.644).结论 NAT2基因慢速乙酰化型町能与ADIH的发生有关.     

盐敏感性高血压易感基因多态性的种族差异性研究

目的 探讨HapMap数据库中四个种族人群盐敏感性高血压易感基因频率的分布差异.方法 利用HapMap数据库中犹他州的欧洲西部和北部的后裔(CEU)、中国北京汉族人(CHB)、日本东京人(JPT)以及尼日利亚的约巴鲁人(YRI)四个种族人群的基因频率数据,建立盐敏感性高血压易感基因多态性(血管紧张肽原基因多态性AGT/M235T、血管紧张素转换酶基因多态性ACE/ID、醛固酮合成酶基因多态性CYP11B2/C344T、α-内收蛋白基因多态性α-adducin/G460T、G蛋白β3亚基基因多态性GNB3/C825T和细胞色素P450 3A酶基因多态性CYP3A5/A6986G)基因数据库(n=395).应用拟合优度卡方检验验证每个基因型分布频率是否符合Hardy-Weinberg平衡定律.利用χ2检验,对不同种族盐敏感性易感基因的基因型频率和等位基因频率进行比较,并进行趋势性检验.同时,运用χ2分割方法 进行两组间的多重比较.结果 四个种族人群盐敏感性易感基因的频率分布存在统计学差异(P＜0.05＝.组间两两比较的结果 发现CHB与JPT人群间的基因型和易感等位基因频率分布没有显著性差异.除了GNB3/825T等位基因频率没有显著性差异(38.8%比34.4%,P=0.521)外,与CEU人群相比,CHB人群的AGT/235T(79.2%比41.2%,P＜0.001＝、ACE/I(56.5%比43.5%,P＜0.001＝、CYP11B2/-344T(74.1%比56.7%,P=0.001)、ADDI/460Trp(51.8%比20.4%,P＜0.001＝和CYP3A5/A6986(30.1%比3.6%,P＜0.001＝等位基因突变频率明显偏高.ADDI/460Trp等位基因在YRI群中分布极低,仅为4%,明显低于CHB人群(51.8%,P＜0.001＝,而AGT/235T、CYP11B2/-334T、GNB3/825T、CYP3A5/6986A基因多态性突变频率均显著地高于CHB人群.根据CEU、CHB、YRI三个人群的趋势性检验的结果 发现,AGT/235T(41.2%＜79.2%＜92.0%,P＜0.001＝、CYP11B2/-334T(56.7%＜74.1%＜84.8%,P＜0.001＝和CYP3A5/6986A(3.6%＜30.1%＜84.5%,P＜0.001＝三个盐敏感性易感基因所携带的突变等位基因型频率呈现显著增加趋势.结论 利用HapMap数据库提供的四个种族基因多态性检测数据进行分析的结果 提示我们,盐敏感性高血压易感基因多态性在不同种族人群中的分布具有显著性差异.北京汉族人群盐敏感性易感等位基因的频率近似于JPT人群,高于CEU人群而低于YRI人群,说明北京汉族人群有较高的盐敏感性,针对高危人群进行预防和个体化治疗将有助于降低盐敏感性高血压和心血管疾病的发生.     

遵义人群载脂蛋白A5 c.553G/T基因多态性与混合型高脂血症的相关性研究

目的 探讨遵义人群载脂蛋白A5(ApoA5)基因c.553G/T位点多态性与混合型高脂血症的相关性.方法 收集222名遵义地区人群静脉血标本,其中混合型高脂血症组100例,正常对照组122名,用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测两组标本ApoA5基因c.553G/T位点多态性,分析混合型高脂血症组和正常对照组中基因型频率和基因频率分布规律,及其与混合型高脂血症的关系.结果 ApoA5 c.553G/T位点基因型频率和基因频率在混合型高脂血症组与正常对照组差异有统计学意义(x2=12.081,P=0.001;x2=17.469,P＜0.001);通过Logistic回归校正年龄、性别、血糖后,T等位基因携带者(TT+ GT基因型)患高脂血症的风险较GG基因型携带者增加(OR=6.042,95％CI:1.962～18.607,P=0.002).结论 ApoA5 c.553G/T位点多态性与遵义地区人群混合型高脂血症发病存在一定相关性,ApoA5 c.553T等位基因可能是混合型高脂血症的独立危险因素.     

尿苷二磷酸葡萄糖醛酸转移酶1A6基因多态性与抗结核药致肝损害的相关性

目的 探讨尿苷二磷酸葡萄糖醛酸转移酶1A6(UGT1A6)基因多态性与中国唐山地区结核患者抗结核药致肝损害的相关性.方法采用病例对照研究,以抗结核治疗导致肝损害患者202例为病例组,无肝损害者239例为对照组,收集环境因素暴露情况及静脉血.UGT1A6基因多态性分析采用聚合酶链反应限制性片段长度多态方法,利用Hha Ⅰ、Dpn Ⅱ和NsiⅠ内切酶分析其基因多态性,以SPSS13.0软件对各危险因素进行单因素和多因素非条件Logistic回归分析.结果 UGT1A6的19T/G、308C/A和541A/G多态性位点均存在3种基因型,UGT1A6-19T/T、UGT1A6-19T/G和UGT1A6-19G/G在病例组和对照组的频率分别为51.5%、39.6%、8.9%和71.1%、25.5%、3.3%;UGT1A6-308C/C、UGT1A6-308C/A和UGT1A6-308A/A在病例组和对照组的频率分别为52.0%、40.6%、7.4%和79.1%、19.2%、1.7%; UGT1A6-541AA、UGT1A6-541A/G和UGT1A6-541G/G在病例组和对照组的频率分别为57.9%、33.7%、8.4%和79.5%、19.2%、1.3%,两组间差异均有统计学意义(x2值分别为17.956、37.385和24.095,P值均＜0.01).单因素和多因素分析均显示UGT1A6-19T/G、-308C/A、-541A/G 3个位点基因多态性与抗结核药致肝损害的发生有关(P值均＜0.05).结论 UGT1A6基因多态性可能与汉族人抗结核药致肝损害的发病有关,且各基因型存在相互作用.

Abstract：

Objective To investigate the relationship between the polymorphisms of UGT1A6 genes and anti-tuberculosis drug induced hepatic-injury (ADIH). Methods 202 cases and 239 controls were collected and a case-control study was conducted. Information on related risk factors of tuberculosis was collected. The genotypes of UGT1A6-19T/G, UGT1A6-308C/A and UGT1A6-541A/G genetic polymorphisms were detected by polymerase chain reaction and restriction fragment length polymorphism technique (PCRRFLP) in patients received anti-tuberculosis therapy. The Hha Ⅰ, Dpn Ⅱ and NsiⅠenzyme were employed.Univariate and multivariate conditional logistic analyses were conducted using SPSS13.0 for windows software.Results The allele frequency of gene UGT1A6-19T/T, UGT1A6-19T/G, UGT1A6-19G/G, GT1A6-308C/C, UGT1A6-308C/A, UGT1A6-308A/A, UGT1A6-541AA, UGT1A6-541A/G and UGT1A6-541G/G in ADIH group were 51.5%, 39.6%, 8.9%, 52.0%, 40.6%, 7.4%, 57.9%, 33.7%, 8.4% and 71.1%, 25.5%, 3.3%,79.1%, 19.2%, 1.7%, 79.5%, 19.2%, 1.3% in control group, respectively. Univariate analysis demonstrated that the frequency of UGT1A6-19T/G, UGT1A6-308C/A and UGT1A6-541A/G genotype in cases were significantly higher than that in controls (P ＜ 0.05). Conclusion A positive association is found between UGT1A6 genotype and the occurrence of ADIH. The synergetic effect is proved on susceptibility to pulmonary tuberculosis between UGT1A6 mutant genotypes.     

凝血酶激活的纤溶抑制物编码区基因多态性与心肌梗死相关性探讨

目的：探讨TAFI编码区基因单核苷酸多态性与心肌梗死（MI）的关系。方法：应用聚合酶链反应-限制性内切酶片段长度多态性分析技术（PCR-RFLP）检测100例MI患者和90例正常对照者的CPB2基因2个位点G505A和C1040T的多态性。结果：CPB2基因G505A位点的3种基因型（G505G、G505A、A505A）频率在MI组和对照组分别为35（35%）、54（54%）、11（11%）和32（35.6%）、46（51.1%）、22（24.4%）,等位基因G、A频率在MI组和对照组分别为124（62.0%）、76（38.0%）和110（61.1%）、70（38.9%）;C1040T位点的3种基因型（C1040C、C1040T、T1040T）频率在MI组和对照组分别为32（32%）、53（53%）、15（15%）和31（31.4%）、49（54.4%）、10（11.2%）,等位基因C、T频率在MI组和对照组分别为117（58.5%）、83（41.5%）和111（61.7%）、69（38.3%）,2组之间基因型及等位基因频率分布差异无统计学意义（G505A位点：χ^2=1.6757,P=0.8524;χ^2=0.7881,P=0.6973;C1040T位点：χ^2=0.6482,P=0.3958;χ^2=0.7231,P=0.5291）。结论：编码TAFI的CPB2基因2个位点G505A和C1040T的基因多态性与MI没有明显关系。     

CYP2C19基因多态性与缺血性脑卒中发病及预后的相关性

目的探讨细胞色素P450药物代谢酶(CYP)2C19基因多态性对老年缺血性脑卒中(ISS)发病及预后的影响。方法将2014年1月至2016年6月收治的老年ISS患者120例作为ISS组,另选取同期健康体检者120例作为对照组,ISS组给予氯吡格雷75 mg/d持续治疗12个月,采用聚合酶链式反应-限制性片段长度多态性法(PCR-RFLP)检测CYP2C19基因型,血栓弹力图法检测ISS组血小板聚集抑制率,分析CYP2C19基因型与ISS发生、氯吡格雷抵抗的相关性,并对预后影响因素进行非条件多因素Logistic回归分析。结果 ISS组CYP2C19 G681A位点AA型基因、G636A位点AA型、AG型基因频率显著高于对照组,差异有统计学意义(P0.05);氯吡格雷抵抗组CYP2C19基因G681A位点AG型、AA型频率显著高于敏感组,差异有统计学意义(P0.05);多因素Logistic回归分析显示糖尿病、氯吡格雷抵抗、携带CYP2C19基因G681A位点AA型是老年ISS患者不良预后的独立危险因素(P0.05)。结论 CYP2C19老年G681A位点AA型基因及G636A位点AA型、AG型基因是老年ISS发病的易感基因,而CYP2C19 G681A位点AG型、AA型基因与氯吡格雷抵抗密切相关。此外,G681A位点AA型基因是老年ISS患者不良预后的独立危险因素。     

内皮型一氧化氮合酶和N5，N10-亚甲基四氢叶酸还原酶基因多态性与苏皖地区汉族人群早发冠心病易感性的相关关系

目的 探讨内皮型一氧化氮合酶(eNOS)基因第7外显子G894T突变和N5,N10-亚甲基四氢叶酸还原酶(MTHFR)基因C677T突变与苏皖地区汉族人群早发冠心病(PCAD)发病的关系.方法 采用病例对照研究的方法,应用聚合酶链反应-限制性片长多态性(PCR-RFLP)技术,分别检测131例PCAD患者(PCAD组)和131例年龄、性别相匹配的无冠心病者(对照组)的eNOS和MTHFR基因的单核苷酸多态性,判定其基因型并统计各基因型及等位基因的频率.结果 eNOS基因G894T多态性在PCAD组和对照组中的基因型分布(x2=2.072,P=0.355)和T等位基因频率(x2=0.727,P=0.394)差异均无统计学意义.MTHFR基因C677T基因型在PCAD组CT和TT型分布均高于对照组(x2 =14.290,P=0.001),T等位基因频率亦高于对照组(x2=16.339,P =0.000),差异有显著性(P＜0.05).Logistic回归分析显示,携带MTHFR基因C677TTT基因型是PCAD发病的独立危险因素.结论 eNOS基因G894T多态性可能与苏皖地区汉族人群PCAD发病无关;MTHFR基因677C/T多态性的TT基因型可能增加苏皖地区汉族人群PCAD的患病风险,T等位基因可能是PCAD的遗传易感基因.     

PCI术后患者氯吡格雷反应性与CYP2C19基因多态性的相关性研究

目的观察冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠脉介入术(PCI)后的氯吡格雷低反应与CYP2C19基因型多态性的相关性。方法选择2015年8月～2017年8月于河南大学第一附属医院心内科收治的择期行PCI术的164例冠心病患者为研究对象,均接受氯吡格雷干预治疗。按照血小板抑制率将其分为氯吡格雷正常反应组(NCLR)102例与氯吡格雷低反应组(CLR)62例。对比两组临床基本资料,采用DNA微阵列芯片法测定CYP2C19基因多态性,比较基因型分布特征、CLR影响因素。结果CLR组胆固醇水平显著低于NCLR组(P0.05),体质指数(BMI)25 kg/m2、2型糖尿病所占比例明显高于NCLR组(P0.05)。164例患者中CYP2C19*2位点三种基因型G/G、G/A、A/A分别占48.78%、38.41%、12.81%,等位基因G、A频率分别为68.29%、31.71%;CYP2C19*3位点三种基因型G/G、G/A、A/A分别占93.90%、2.44%、3.66%,等位基因G、A频率分别为95.43%、4.57%。CLR组CYP2C19*2位点G/A、A/A基因型频率与A等位基因频率显著高于NCLR组(P0.05),G/G基因型与G等位基因频率较NCLR组无统计学意义(P0.05);CLR组CYP2C19*3位点各基因型和等位基因频率分布较NCLR组无统计学意义(P0.05)。经Cox回归分析,结果显示CYP2C19*2基因突变、体质指数25 kg/m2、2型糖尿病是冠心病PCI术患者CLR的独立影响因素(P0.05)。结论 CYP2C19*2基因突变、体质指数25kg/m2、2型糖尿病是氯吡格雷干预后冠心病PCI术后患者出现CLR的独立危险因素。     

肾素-血管紧张素-醛固酮系统基因多态性与大动脉粥样硬化性卒中的相关性:中国南方汉族人群研究

目的 研究肾素-血管紧张素-醛固酮系统血管紧张素原(angiotensinogen,AGT)基因M235T、血管紧张素Ⅱ1型受体(angiot ensinⅡtype 1 receptor,AGTR1)基因A1166C、醛固酮合酶( aldosterone synthase,CYP11B2)基因- 344C/T多态性与中国南方汉族人群大动脉粥样硬化性卒中(large-artery atherosclerosis,LAA)的相关性.方法 采用聚合酶链反应和基因测序技术对中国南方汉族LAA患者和正常对照者AGT基因M235T、ATGR1基因A1166C和CYP11B2基因- 344C/T多态性进行基因分型,并通过二分类logistic回归分析确定这3种基因多态性与LAA的相关性.结果 共纳入LAA患者107例和142名健康对照者.LAA组AGT基因235TT基因型(66.36％对50.70％,x2=6.122,P=0.047)和T等位基因(79.44％对70.07％,x2=5.581,P=0.018)频率显著高于对照组,AGTR1基因1166CC基因型(0％对0％,x2=1.494,P=0.222)和C等位基因(7.48％对4.93％,x2=1.399,P=0.237)频率与对照组无显著性差异,CYP11B2基因- 344CC基因型(9.35％对4.23％,x2=3.603,P=0.165)和C等位基因(27.10％对26.06％,x2=0.069,P=0.793)频率与对照组亦无显著性差异.二分类logistic回归分析显示,这3种基因多态性与单纯性LAA患病均无显著相关性.合并高血压的LAA患者AGT基因235TT基因型(68.00％对41.90％,x2=12.446,P=0.002)和T等位基因(79.33％对64.76％,x2=8.993,P=0.003)频率均显著高于血压正常对照组,logistic回归分析显示,暴露于TT基因型的优势比(odds ratio,OR)为2.153[ 95％可信区间(confidence interval,CI)0.789 ～5.872],T等位基因的OR值为2.089(95％ CI1.285 ～3.396).结论 AGT基因M235T多态性与南方汉族人群单纯性LAA无关,但可能与合并高血压的LAA患病风险相关;CYP11B2基因- 344C/T多态性和AGTR1基因A1166C多态性与南方汉族人群LAA发病无关.     

肝硬化患者人类白细胞抗原-DRB1和DPB1基因多态性的临床意义

目的 探讨人类白细胞抗原(HLA)-DRB1和DPB1基因多态性与肝硬化易感性的关联.方法 收集肝硬化患者168例作为研究组,其生物学父母作为对照组.运用聚合酶链反应扩增及单核苷酸多态性的分子生物学技术,检测HLA-DRB1和DPB1基因rs24755213、rs202176660基因多态性,进行肝硬化与HLA-DRB1和DPB1基因多态性的关联分析和单体型相对风险率分析.哈迪温伯格吻合度检验进行群体分析,P＜ 0.05为差异有统计学意义. 结果 HLA-DRB1单核苷酸多态性基因(SNP)位点rs24755213为A/G两种基因型,HLA-DPB1基因SNP位点rs202176660为C/T两种基因型,Hardy-Weinberg平衡检验结果表明吻合度良好;HLA-DRBI和DPB1基因SNP位点rs24755213与肝硬化相关联(P=0.014),其中等位基因A为危险因素(Z=2.33),G是保护因素(Z=-2.33);rs202176660等位基因多态性与肝硬化相关联(P=0.026),其中等位基因C是保护因素(Z=-2.06),T为危险因素(Z=2.06).rs24755213、-rs202176660单体型的G/T、A/C与肝硬化相关联(Z值分别为-2.12、2.09,P值分别为0.037、0.002). 结论 HLA-DRB1和DPB1基因的单核苷酸表型差异与肝硬化的发生和发展关系密切.     

Profile of polymorphisms of drug-metabolising enzymes and the risk of therapy-related leukaemia

Therapy-related acute myeloid leukaemia/myelodysplastic syndrome (t-AML/t-MDS) results from an impaired ability to detoxify chemotherapeutic drugs or repair drug-induced genetic damage caused by genetic polymorphisms in enzymes involved in the metabolism of drugs. We analysed the prevalence of genetic polymorphisms of CYP1A1*2A(T6235C), CYP2E1*5B(C-1019T), CYP3A4*1B(A-290G), del{GSTT1}, del{GSTM1}, NQO1*2(C609T), MTHFR(C677T) and TYMS 2R/3R in 78 t-AML/t-MDS and 458 normal individuals (control group, CG) using real-time and conventional polymerase chain reaction (PCR)-based methods. The incidences of polymorphisms among t-AML/t-MDS patients and CG individuals were similar. However, a polymorphism profile consisting of CYP1A1*2A, del{GSTT1} and NQO1*2 strongly modified the risk of t-AML/t-MDS. The absence of all three polymorphisms decreased the risk of t-AML/t-MDS 18-fold (odds ratio (OR) = 0.054, 95% confidence interval (CI) = 0.005-0.63, P = 0.02), whereas the presence of only NQO1*2 or all three polymorphisms enhanced the risk of t-AML/t-MDS (OR = 2.09, 95% CI = 1.08-4.03, P = 0.03 and OR = 18.42, 95% CI = 1.59-212.76, P = 0.02 respectively). Thus, the profiles of genetic polymorphisms of drug-metabolising enzymes might explain the increased risk to t-AML/t-MDS observed in some patients treated with polychemotherapy.     

Cytochrome P450 2E1 genotype and the susceptibility to antituberculosis drug-induced hepatitis

Most cases with antituberculosis drug-induced hepatitis have been attributed to isoniazid. Isoniazid is metabolized by hepatic N-acetyltransferase (NAT) and cytochrome P450 2E1 (CYP2E1) to form hepatotoxins. However, the role of CYP2E1 in this hepatotoxicity has not yet been reported. The aim of this study was to evaluate whether the polymorphism of the CYP2E1 gene is associated with antituberculosis drug-induced hepatitis. A total of 318 tuberculosis patients who received antituberculosis treatment were followed prospectively. Their CYP2E1 and NAT2 genotypes were determined using a polymerase chain reaction with restriction fragment length polymorphism method. Twenty-one healthy volunteers were recruited for CYP2E1 phenotype study using a chlorzoxazone test. Forty-nine (15.4%) patients were diagnosed to have drug-induced hepatotoxicity. Patients with homozygous wild genotype CYP2E1 c1/c1 had a higher risk of hepatotoxicity (20.0%; odds ratio [OR], 2.52) than those with mutant allele c2 (CYP2E1 c1/c2 or c2/c2, 9.0%, P =.009). If CYP2E1 c1/c2 or c2/c2 genotype combined with rapid acetylator status was regarded as the reference group, the risk of hepatotoxicity increased from 3.94 for CYP2E1 c1/c1 with rapid acetylator status to 7.43 for CYP2E1 c1/c1 with slow acetylator status. After adjustment for acetylator status and age, the CYP2E1 c1/c1 genotype remained an independent risk factor for hepatotoxicity (OR, 2.38; P =.017). Furthermore, under the administration of isoniazid, the volunteers with CYP2E1 c1/c1 genotype had higher CYP2E1 activity than those with other genotypes had and, hence, might produce more hepatotoxins. In conclusion, CYP 2E1 genetic polymorphism may be associated with susceptibility to antituberculosis drug-induced hepatitis.     

谷胱甘肽S-转移酶M1及T1基因突变对抗结核药致肝损伤的影响

目的 探讨谷胱甘肽S-转移酶(GST)M1、T1基因多态性与抗结核药所致肝损伤(ADIH)的相关性.方法 2005年8月至2006年7月,采用1∶1配对病例对照研究设计,选择从接受抗结核化疗开始随访3个月期间出现肝损伤(病例组106例)及未见肝损伤(对照组106例)的结核病患者,病例组男73例,女33例,年龄15～88岁,平均(49±19)岁;对照组男73例,女33例,年龄17～85岁,平均(49±19)岁.应用PCR技术检测研究对象的GST M1和GST T1基因多态性,采用单因素和多因素logistic回归分析GST基因型与ADIH的关系.结果 单因素分析结果 表明,病例组GST M1基因缺失型50例(47.2%),明显多于对照组的25例(23.6%),OR值为2.786(95%CI为1.513～5.130);病例组和对照组GST T1各基因型频率比较差异无统计学意义;在文化程度、职业、体重指数、吸烟、饮酒和结核类型6个可疑危险因素中,仅体重指数和饮酒具有统计学意义.在多因素分析中调整体重指数、饮酒两个因素后,GST M1基因缺失型仍与ADIH的发生显著相关,OR值为3.022(95%CI为1.540～5.926),仍未发现病例组和对照组GST T1基因型频率与ADIH的发生有关.结论 GST M1基因缺失型可能是抗结核治疗患者发生肝损伤的易感基因型.     

Interaction of methylenetetrahydrofolate reductase C677T,cytochrome P4502E1 polymorphism and environment factors in esophageal cancer in Kazakh population

AIM： To evaluate the association and interaction of genetic polymorphisms in methylenetetrahydrofolate reductase （MTHER） and cytochrome P4502E1 （CY- P4502E1）, environment risk factors with esophageal cancer （EC） in Kazakh, a high EC incidence area of Xinjiang Uygur Autonomous Region, China. METHODS： A 1：2 matched case-control study was conducted with 120 cases of EC and 240 populationor hospital-based controls. The controls were matched for sex, nationality, area of residence and age within a 5-year difference. MTHER and CYP4502E1 genotypes were identified by PCR-based restriction fragment length polymorphism （RFLP）. A conditional logistic regression model was established to identify risk factors. The strata method was adopted in interaction analysis. RESULTS： Low consumption of green vegetables and fresh fruits, alcohol drinking, and unsafe water （shallow well, or river） were found to be the risk factors for EC. Individuals with the MTHFR677 （C/T ＋ T/T） genotype had a 2.62-fold （95% CI： 1.61-4.28） risk of developing EC compared with those who carried the C/C genotype. Individuals with the CYP4502EIC1/C1 genotype had a 3.00-fold （95% CI： 1.82-4.96） risk compared with those who carried the CYP4502E1 （C1/C2 ＋ C2/C2） genotype. Gene-environment interaction analysis showed that MTHFR677 gene polymorphism was correlated with consumption of green vegetables and fresh fruit, while CYP4502E1 C1/C1 was correlated with alcohol drinking and unsafe drinking water. MTHFR and CYP4502E1 analysis of gene-gene interaction showed that individuals with the MTHFR677 （C/T ＋ T/T） and CYP4502EIC1/ C1 genotypes had a 7.41-fold （95% CI： 3.60-15.25） risk of developing EC compared with those who carried the MTHFR677C/C and CYP4502E1 RsaI C1/C2 ＋ C2/C2 genes, and the interaction rate was higher than that of the two factors alone. CONCLUSION： Low consumption of green vegetables and fresh fruits, alcohol drinking, and unsafe water （shallow well, or river） and polymorphisms     

CACNA1C基因多态性与钙通道阻滞剂降压疗效的关系

目的 探讨L型钙离子通道 alc 哑基基因(CACNAlC)多态性对钙离子通道阻滞剂治疗原发性高血压(EH)患者疗效的影响.方法 对103例EH患者,给单一硝苯地平缓释片进行6周的治疗,采用多重聚合酶链反应方法(Multi-PCR)及基质辅助激光解析-飞行时间质谱分析技术(MLDI-TOF MS)对 rs216008、rs1051375、rs2299661、rs10848683、rs215976进行分型,分析不同基因型间治疗前后血压变化的差值.结果(1)与治疗前相比,硝苯地平缓释片治疗后所有患者平均收缩压和舒张压均出现明显下降(P＜0.05).(2)rs2299661的CC型舒张压下降幅度明显高于CG型和GG型[(12.46±7.91)mm Hg(1 mm Hg =0.133 kPa)比(7.22±8.01)mm Hg和(5.93±9.77)mm Hg,P＜0.05].(3)rs216008的CC型收缩压下降幅度明显高于CT型[(20.60±12.35)mm Hg比(13.62±10.21)mm Hg,P＜0.05],但与TT型比较差异无统计学意义.(4)rs1051375、rs10848683、rs215976的各基因型间血压变化差值无统计学意义.结论 CACNAI C rs2299661、rs216008的CC型可能会使硝苯地平缓释片治疗EH患者的疗效具更为突出.     

细胞色素P4501A1基因多态性和谷胱甘肽硫转移酶基因缺失及烹调油烟暴露与非吸烟女性肺癌易感性的关系

目的 探讨细胞色素P4501 A1(CYP1A1)MspI位点多态性、谷胱甘肽硫转移酶(GSTM1)基因缺失及烹调油烟暴露与非吸烟女性肺癌易感性的关系.方法 2009年3一12月选择中南大学湘雅医院女性非吸烟的原发性肺癌患者及对照各160例,应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)及聚合酶链反应(PCR)技术分别检测CYP1A1 MspI多态性及GSTM1基因型,分析基因的多态性、分型及烹调油烟暴露与肺癌遗传易感性的关系.结果 肺癌组及对照组烹调油烟暴露的频率分别为51.9%(83例)及33.7%(54例),差异有统计学意义(x2=10.734,P＜0.01);肺癌组MspI位点突变的等位基因频率为44.4%(71例),高于对照组(36.9%,59例),差异无统计学意义(X2=3.731,P＞0.05);携带突变型或杂合型基因同时又有油烟暴露个体患肺癌的风险明显增高,OR(odds ratio)值分别为3.032(95%CI为1.291～7.124)和2.769(95%CI为1.341～5.552);肺癌组GSTM1缺失型的频率为58.1%(93例),与对照组(45.0%,72例)比较,差异有统计学意义(X2=0.518,P＜0.05),GSTM1缺失型的个体患肺癌的风险明显增高,OR值为1.697(95%CI为1.090～2.640);携带GSTM1缺失型且有烹调油烟暴露的个体肺癌的易感性明显增加,其OR值为3.617(95%CI为1.899～6.891);GSTM1缺失型与CYP1A1 MspI杂合型或突变型联合作用时,个体患肺癌的风险亦增高,OR值分别为1.966(95%CI为1.007～3.836)和2.402(95%CI为1.023～5.640),差异明显.结论 烹调油烟暴露是非吸烟女性肺癌的危险因素;CYP1A1 MspI基因多态性与烹调油烟联合作用可增加肺癌发病的风险;GSTM1基因缺失可能是非吸烟女性肺癌的遗传易感因素,其与烹调油烟暴露联合作用可明显增加肺癌发病的风险,且GSTM1基因缺失与CYP1A1基因多态性存在交互作用.