急性冠脉综合征发生的遗传与行为交互作用分析

目的 探讨行为、遗传因素及其交互作用对急性冠脉综合征发生的作用.方法 对2009年6～12月在济宁医学院附属医院心血管内科病房住院的134例心血管病患者均行选择性冠状动脉造影或冠状动脉CT检查,结果发现急性冠脉综合征84例,同时选择同期住院的非冠心病患者50例.详细记录所有研究对象的一般情况、现病史、既往史及行为因素资料,并检测其所有研究对象的补体因子H(CFH Y402H)基因型.比较两组行为和CFH Y402H基因型和等位基因频率分布,对所有可能的影响因素并进行单因素和多因素Logistic回归分析.结果 单因素Logistic回归分析显示:吸烟史(P=0.000,OR=4.894,OR 95% CI:2.537～9.441)、饮酒史(P=0.008,OR=2.879,OR 95% CI:1.499～5.528)、高血压病史(P=0.000,OR=4.222,OR 95%CI:2.195～8.123)、健身活动(P=0.002,OR=0.333,OR 95%CI:0.188～0.589)、盐摄人(P=0.006,OR=0.457,OR 95%CI:0.287～0.727)、性格(P=0.000,OR=0.385,OR 95% CI:0.247～0.600)、职业紧张(P=0.015,OR=2.118,OR 95% CI:1.278～3.511)与中国北方汉族人急性冠脉综合征有关.多因素Logistic回归分析显示:吸烟史(P=0.010,OR=6.084,OR 95% CI:1.543～23.988)、高血压病史(P=0.024,OR=2.821,OR 95% CI:1.143～6.595)、健身活动(P=0.004,OR=0.297,OR 95% CI:0.130～0.678)、性格(P=0.011,OR=0.435,OR 95% CI:0.229～0.829)与急性冠脉综合征发病有显著相关性.结论 有吸烟史、高血压病史、性格急躁是急性冠脉综合征发病的危险因素,而健身活动则是保护因素.

The interaction analysis of genetic and behavioral factors on the occurrence of acute coronary syndrome

Objective To explore the the interaction analysis of genetic and behavioral factors on the occurrence of acute coronary syndrome. Methods This study consisted of 134 subjects between June 2009 and Dec.2009 from affiliated hospital of Jining Medical University, All subjects underwented selective coronary angiography or coronary artery CT. Coronary artery disease based on the results of coronary angiography or coronary artery CT that at least one coronary artery diameter reduction of more than 50% and fulfilled the diagnostic criteria of ACC/AHA. 84 patients with acute coronary syndrome and 50 controls, and general informations, current disease history,past medical history, related be havioral factors were collected. DNA was extracted from acute coronary syndromepatients and healthy control subjects, stored in -20 ℃. The genotype of CFH Y402H was detected by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP) methods in acute coronary syndrome patients and controls. PCR amplification products was verificated by electrophoresis on agarose gel. Deviation of genotype distribution form Hardy-Weinberg equilibrium was assessed using x2 test in each group. Univariate and multivariate conditional logistic analyses were conducted in the end. Results The results showed that smoking history (P=0.000, OR =4.894,OR 95% CI:2.537 ～9.441 ), alcohol drinking history(P= 0.008,OR =2.879,OR 95% CI: 1.499 ～ 5.528 ), hypertension (P = 0.000, OR = 4.222, OR 95% CI: 2.195 ～ 8.123), sports activities (P =0.002,OR =0.333, OR 95% CI:0.188 ～ 0.589 ), salt intake (P= 0.006, OR = 0.457, OR 95% CI:0.287 ～0.727 ), character(P = 0.000, OR = 0.385, OR 95% CI :0.247 ～ 0.600 ) stress of occupations (P = 0.015, OR =2.118, OR 95% CI: 1.278 ～ 3.511 ) were associated with acute coronary syndrome of Northern Chinese Han population. Smoking history(P = 0.010, OR = 6.084, OR 95% CI: 1.543 ～ 23.988), hypertension (P= 0.024, OR =2.821, OR 95% CI: 1.143 ～ 6.595 ), sports activities (P= 0.004, OR = 0.297, OR 95% CI:0.130 ～ 0.678 ), personality(P= 0.011, OR = 0.435, OR 95% CI:0.229 ～ 0.829 ) were significantly associated with acute coronary syndrome in multivariate conditional logistic analyses after adjusting other factors. Conclusions Smoking history,hypertension, personality are risk factors of acute coronary syndrome of Northern Chinese Han population. Butsports activities is protective factors.