肾素-血管紧张素系统双基因多态性与高血压合并舒张性心力衰竭的关系

目的探讨中国南方部分汉族高血压患者肾素一血管紧张素系统中血管紧张素转换酶（ACE）及血管紧张素原（AGT）双基因多态性与舒张性心力衰竭发病的关系。方法应用聚合酶链反应及限制性片断长度多态性技术，对432例高血压患者的ACE基因插入／缺失（I／D）及AGTM235T多态性进行检测。将其中207例合并舒张性心力衰竭者作为病例组，其余225例心功能正常者作为对照组。结果①病例组DD基因型及D等位基因的频率均高于对照组；②病例组TT基因型及T等位基因的频率与对照组比较差异无统计学意义；③联合分析ACE与ACT基因多态性显示，两组中同时具有DD型ACE基因及TT型AGT基因的频率分别为29．0％及14．9％，前者明显高于后者。结论DD型ACE基因可能是该地区高血压患者舒张性心力衰竭发病的遗传危险因素，ACE和AGT基因在慢性心力衰竭的发生中具有协同作用。

Relationship between renin-angiotensin system gene polymorphism and diastolic heart failure with hypertension

Objective To investigate the relationship between angiotensin-eonverting enzyme （ACE）gene insertion/deletion （I/D） and angiotensinogen （ACT） gene M235T polymorphism and the onset of diastolic heart failure （DHF） in South Chinese people with hypertension. Methods ACE gene I/D and AGT gene M235T polymorphisms were analyzed in 432 patients with hypertension, the gene polymorphisms were detected by polymerase chain reaction and restriction fragment length polymorphism methods. Genotype distributions were examined in 207 consecutive patients with DHF and 225 patients without DHF. Results （1）The frequencies of DD genotype and D allele were higher in patients with DHF than in their corresponding controls respectively. （2）The frequencies of TT genotypes and T allele were the same in patients with DHF and in their corresponding controls respectively. （3）In combined genotype analysis, the genotype of ACE DD ＋ACT TT was significantly higher in patients with DHF. Conclusion ACE gene I/D polymorphism play roles in the onset of DHF in South Chinese people with hypertension, the DD genotype might be the genetic risk factors of DHF in this area. AGT and ACE gene might play an in- teraction role in the onset of DHF, combined analysis of the ACE-DD and AGT-TT genotype may enhance the predictability of DHF.