脑梗死患者血管紧张素转换酶基因多态性与脑血流动力学的关系

目的探讨脑梗死患者血管紧张素转换酶（ACE）基因多态性与颅内动脉血流动力学的关系。方法应用聚合酶链反应（PCR）测定146例脑梗死患者ACE基因插入／缺失（D／I）多态性，以经颅多普勒超声（TCD）检测大脑主要动脉血流速度，并与对照组比较。结果观察组ACEDD基因型频率为41％，明显高于对照组的27％（P〈0.01）。观察组ACEDD基因型大脑中动脉（MCA）的平均血流速度（Vm）及脉动指数（PI）明显高于对照组，而观察组DI、II基因型MCA的Vm与对照组比较差异均无统计学意义（均P〉005）。伴MCA狭窄且脑梗死发病年龄〉60岁者的ACEDD基因型频率为0.5，明显高于发病年龄≤60岁者（P〈005）。前者MCA中重度狭窄的ACEDD基因型频率为485％，明显高于同基因型发病年龄≤60岁者的11．1％（P〈0．05）。结论年龄在60岁以上ACEDD基因携带者可能是通过引起脑动脉狭窄性改变而致脑梗死。

Angiotensin converting enzyme gene polymorphism and cerebral hemodynamics in patients with cerebral infarction

Objective TO evaluate the relationship between angiotensin-converting enzyme （ACE） gene polymorphism and the hemadynamics of cerebral arterial in patients with cerebral infarction. Methods One hundred and forty six patients with cerebral infarction and 103 control subjects of the Han nationality were enrolled in the study. The ACE polymorphism was examined by polymerase chain reaction （PCR） using peripheral blood samples, while the cerebral arterial velocity was measured by transcranial Doppler sonography （TCD）. Results compared with normal controls, ACE DD genotype was more common in patients of cerebral infarction （41% versus 27%, P〈0.01）. Mean velocity and pulse index of middle cerebral arterial（MCA）in patients with ACE DD genotype were higher than that in controls （P〈0.05）. The frequency of ACE DD genotype in patients aged over 60 with MCA stenosis was higher than that of the younger patients. （P〈0.05） Conclusion The ACE gene deletion polymorphism might be associated with the intracranial stenosis and cerebral infarction in Chinese Han nationality, particularly in patients aged over 60.