原发性高血压患者ACE2基因G8790A多态性与心房颤动的相关性研究

目的:探讨中国河南豫北地区原发性高血压人群血管紧张素转化酶2(ACE2)基因G8790A多态性与心房颤动(Af)的关系。方法:运用病例-对照法,选择953例原发性高血压患者,运用PCR-RFLP对其中475例伴Af(Af组)和478例窦性心律者(非Af组)的ACE2基因G8790A多态性进行基因分型及分析。结果:ACE2基因G8790A等位基因G在男性中的频率:Af组157例(72.0%),非Af组100例(59.5%),差异有统计学意义(P<0.05);在女性中的频率:Af组291例(56.6%),非Af组280例(45.2%),差异有统计学意义(P<0.05)。携带等位基因G的高血压男、女患者发生Af的危险性均增加(OR:1.82,95%CI:1.15～3.07;OR:1.99,95%CI:1.29～5.01,P<0.05)。基因型AA、AG和GG在Af组女性的频率分别为47例(18.3%)、130例(50.6%)和80例(31.1%),在非Af组分别为98例(31.6%)、136例(43.9%)、76例(24.5%),两组基因型分布差异有统计学意义(P<0.05)。与AA基因型相比,携带GG基因型的女性原发性高血压患者发生Af危险性增加(OR=2.05,95%CI:1.390～3.403),男性携带G等位基因和女性携带GG基因型的高血压并发Af患者左心房内径明显增大(P<0.05),女性携带GG基因型者左心室射血分数明显降低(P<0.05)。结论:ACE2基因G8790A多态性与原发性高血压患者Af的发生存在相关性,男女性携带G等位基因和女性携带GG基因型可能使原发性高血压发生Af的危险性增加。

Relation of ACE2 gene G8790A polymorphism and atrialfibrillation in patients with primary hypertension

Objective:To investigate the potential association of angiotensin-converting enzyme 2(ACE2) gene G8790A polymorphism with atrial fibrillation(Af) in primary hypertensive patients in Yubei district of Henan province. Method:A total of 953 patients with primary hypertension were recruited,among 475 with Af(Af group) and 478 with sinus rhythm(Non-Af group).ACE2 8790G/A polymorphism was detected by PCR-RFLP. Result:The G allele frequencies of ACE2 gene in male was 157(72.0%) in Af group and 100(59.5%) in Non-Af group(P<0.01),while in femal was 291(56.6%) in Af group and 280(45.2%) in Non-Af group(P<0.05);The risk of Af increased in male and female patients who carried G allele than those carried A allele(male: OR: 1.82,95%CI: 1.15-3.07;female: OR: 1.99,95%CI: 1.29-5.01).The frequencies of AA,AG and GG in female wre 47(18.3%),130(50.6%) and 80(31.1%) in Af group,while 98(31.6%),136(43.9%) and 76(24.5%) in Non-Af group(P<0.05).Compared with AA genotype,GG genotype increased the risk of Af in female patients with primary hypertension(OR=2.05,95%CI: 1.390-3.403).G allele in male and GG genotype in female significantly increased left atrial diameter,and the latter decreased left ventricular ejection fractions in patients with Af. Conclusion:The development of Af in patients with primary hypertension may be associated with ACE2 genotypes,and polymorphism of ACE2 8790G/A may play a role in occurrence of Af in hypertensive patients.