急性心肌梗死患者血管紧张素Ⅰ转换酶基因多态性及其活性的相关研究

目的探讨血管紧张素Ⅰ转换酶(ACE)插入/缺失(I/D)基因多态性和血清ACE活性与急性心肌梗死(AMI)患者的意义。方法用聚合酶链反应(PCR)法扩增ACE基因第16内含子多态性位点的序列,检测38例AMI患者及32名健康体检者ACE基因,χ2检验比较心肌梗死组、对照组间ACE基因型的频率及等位基因频率。用速率法检测血清ACE活性水平。对C反应蛋白(CRP)、肌酸激酶同工酶(CK-MB)质量、心肌肌钙蛋白(cTNI)含量也进行了检测。结果与对照组比较,AMI患者ACE基因型有明显的分布差异。三种基因型III、D、DD的频率在AMI患者分别为5/38(13%)、14/38(37%)、19/38(50%),在对照组则分别为8/32(25%)、17/32(53%)、7/32(22%)。I、D等位基因频率在AMI组分别为24/76(32%)、52/76(68%);对照组分别为33/64(52%)、31/64(48%)。经χ2检验,差异有统计学意义。ACE基因型与血清ACE浓度相关,DD、ID、II基因型的ACE浓度分别为(61±16)U/L、(49±14)U/L(、38±14)U/L。DD基因型患者的血清cTNI的表达水平明显高于ID型和II型,CRP在各基因型之间差异无统计学意义。结论AMI患者血清ACE活性明显升高。ACE基因型与血清ACE浓度相关,DD型表达最高,II型最低,ID型介于两者之间。DD基因型患者的血清cTNI的表达水平明显高于ID型和II型。

The relationship between insertion/deletion gene polymorphism and serum enzyme levels of angiotensin Ⅰ-converting enzyme gene in acute myocardial infarction

Objective To study the relationship of insertion/deletion gene polymorphism and serum levels of angiotensin Ⅰ converting enzyme(ACE) in acute myocardial infarction(AMI).Methods Thirty-eight patients with AMI and 32 healthy controls were evaluated,comparing their ACE allele and genotype frequencies in each group by chi-square test;serum ACE activity level and C-reactive protein(CRP),creatine kinase-MB mass and cardiac troponin I were also checked.Results Genotype frequencies of AMI patients were significantly different from those of the control group.The three genotype frequencies II,ID,DD were 5/38(13%),14/38(37%),19/38(50%) respectively in AMI patients,and 8/32(25%),17/32(53%),7/32(22%)in the control group.The ACE allele frequencies were 24/76(32%),52/76(68%) and 33/64(52%),31/64(48%) respectively.The difference was significant by chi-square test.ACE activity in serum was associated with ACE genotypes,the serum level of ACE of DD,ID,II genotype was(61±16)U/L,(49±14)U/L,(38±14) U/L respectively.The serum level of cTNI of the deletion polymorphism genotype was markedly higher than that of other polymorphisms;no difference among serum CRP levels was found in each genotype.Conclusion In AMI patients,the serum level of ACE is higher than that in the controls.ACE insertion/deletion polymorphism correlates to serum ACE concentrations.Subjects with deletion polymorphism have higher ACE levels than those with insertion polymorphism.Intermediate levels are observed in heterozygotes.The serum level of cTNI of the deletion polymorphism is markedly higher than that of other polymorphisms.