肾素-血管紧张素系统基因多态性与冠状动脉血栓疾病

为了观察中国人群中肾素-血管紧张素系统基因多态性的分布特征，并分析这些基因多态性与冠状动脉血栓(CATD)疾病的相关性以及该基因多态性间的相互作用，采用直接聚合酶链式反应(PCR)和PCR-限制性片段长度多态性(PCR—RFLP)方法对192例冠状动脉血栓疾病患者和110例对照组个体进行血管紧张素转换酶(ACE)、血管紧张素原(AGT)和血管紧张素II I型受体(AT1R)基因的基因多态性进行检测。结果表明：①在中国人群中，ACE基因各基因型分布分别为DD12．2％、ID43．9％和II43．9％；AGT基因各基因型分布为MM8．2％，MT36．7％和TT55．1％；AT1R基因各基因型分布分别为AA91．8％和AC8．2％。②冠状动脉血栓疾病组与对照组相比，上述3种基因多态性的分布均无明显差异。③同时携带AT1R—AC和AGT—TT基因型的个体，与AT1R—AA和AGT—TT基因型个体相比，罹患CATD的相对危险度达到3．517(95％C10．988—12．527)；与AC基因型和非TT基因型个体相比，罹患CATD的危险性可增加至15．000(95％CI 1．940—115．963)；在AT1R—AC基因型个体，等位基因D在CATD组和对照组的分布亦存在有明显的差异(P=0．017)。结论：我国人群ACE基因I／D多态性、AGT基因M235T多态性和ATlR基因A1166C多态性各基因型和等位基因的分布明显不同于西方人群；上述3种基因多态性不是我国人群冠状动脉血栓疾病或心肌梗塞的独立的危险因素。但AT1R基因AC基因型与AGT基因TT基因型、AT1R基因AC基因型和ACE基因等位基因D在罹患冠状动脉血栓疾病的危险性上有显著的协同作用。

Gene Polymorphisms of Rennin-Angiotensin System and Coronary Artery Thrombosis Disease

To investigate the distribution frequencies of angiotensin-converting enzyme (ACE), angiotensinogen (AGT), angiotensin II I type receptor (AT1R) genotypes in Chinese, to find the relationships between polymorphisms of ACE, AGT and AT1R gene, and coronary artery thrombosis disease (CATD) and to study the interactions of themselves, PCR and PCR-RFLP techniques were performed to determine the genotypes of ACE, AGT and AT1R gene in CATD group (192 cases) and control group (110 cases). The results showed that (1) genotype frequencies of the three polymorphisms in the control group were 12.2% (DD), 43.9% (ID), and 43.9% (II) for the ACE I/D polymorphism; 8.2% (MM), 36.7% (MT), and 55.1% (TT) for AGT M235T polymorphism; 91.8% (AA), 8.2% (AC) for AT1R A1166C polymorphism respectively; (2) there were no significant differences between patients in either the control group, the non-MI group, or the MI group in any genotype frequency of all these three genes (P >0.05). (3) the odds ratio for CATD in subjects carrying both AT1R-AC and AGT-TT genotype was 3.517 (95% CI 0.988 - 12.527), compared with those carrying AT1R-AA and AGT-TT genotype and was 15.000 (95% CI 1.940-115.963), compared with those carrying AT1R-AC and AGT-MM/MT genotype. In subjects with AT1R-AC genotype, there was also a great difference of ACE D allele frequency between control group and CATD group (P=0.017). It is concluded that genotype frequencies of ACE I/D polymorphism, AGT M235T polymorphism, and AT1R A1166C polymorphism were obviously different from those in western countries. Although these three polymorphisms were not independent risk factors for CATD or myocardial infarction (MI) in Chinese, AT1R-AC genotype has a significant synergistic effect with AGT-TT genotype. There is also a obvious interaction between AT1R-AC genotype and ACE D allele.