摘要
目的:研究CYP11B2-344C/T(醛固酮合成酶)及ACEI/D(血管紧张素转化酶)基因多态性与慢性心力衰竭(CHF)患者实施ACEI治疗后出现醛固酮脱逸表现的关系。方法:回顾分析2008年10月至2012年10月我科收治的252例CHF患者,全部患者应用ACEI治疗3月,醛固酮在基线以上为醛固酮脱逸,依据此标准将患者分为研究组(脱逸组,n=86)与对照组(非脱逸组,n=166),依据PCR(聚合酶链反应)及RFLP(片段长度限制多态性)等方法分别检测两组CYP11B2及ACE基因型,比较两组基因型频率的分布。结果:252例患者中,共86例出现醛固酮脱逸,发生率为34.1%。全部受试患者CYP11B2基因型及ACE基因型频率与Weinberg-Hardy平衡均相符(P均>0.05)。研究组ACE I/D三种基因型的组间分布与对照组相较,无统计学差异(P>0.05);CYP11B2基因TT型的频率与对照组相较,呈明显统计学差异(P<0.05),等位基因C/T频率的组间分布同对照组相较,亦呈明显差异(P<0.05)。研究组ACEI/D的基因多态性及CYP11B2-344C/T的多态性中,基因型联合组间分布与对照组相较,无统计学差异(P>0.05)。结论:ACE基因多态性与CHF患者ACEI治疗后出现醛固酮脱逸无关,CYP11B2基因T等位基因及TT基因型多态性可能是CHF患者ACEI治疗后发生醛固酮脱逸的高危因素。醛固酮脱逸时,ACE、CYP11B2基因不具有协同效果。
Objective： To study the relationship between CYP11B2-344-c/T（aldosterone synthase） and ACEYD（angiotensin con- verting enzyme gene polymorphism and patients with chronic heart failure （CHF） after the implementation of ACEI treatment aldosterone extruding performance. Methods： 252 patients with CHF admitted in our department from October 2008 to October 2012 were, retrospec- tively, analyzed. All the patients were treated by ACEI for 3 months. Aldosterone above baseline was considered as aldosterone escape, patients were divided into research group （extruding group, n=86） and control group （non-extruding group, n=166） according to this stan- dard, PCR （polymerase chain reaction） and RFLP （fragment length polymorphism） method were used to detect and compare the CYP 11 B2 and ACE genotype distribution. Results： In 252 cases of patients, a total of 86 cases （34.1%） with aldosterone extruding were observed, All the patients＇ CYP11B2 gene type and ACE genotype frequency and Weinberg-Hardy balance were consistent （P〉0.05）. No significant difference was found in the three ACE UD genotype distribution between research group and control group （P〉0.05）; the TT frequency of CYP 11 B2 genotype, allele C/T frequency distribution of research group were significantly different from that of the control group（P〈0.05）. No statistical difference was observed in the team of ACEI/D gene polymorphism and CYP11B2-344-c/T polymorphism, genotype distribution between the joint groups compared with control group （P〉0.05）. Conclusion： ACE gene polymorphism had no cor- relation with the aldosterone escape after ACEI treatment of CHF patients, T allele and genotype TT of CYP11B2 gene polymorphisms may be risk factors of aldosterone escape after ACEI treatment, ACE, CYP11B2 gene hadn＇t synergistic effect during the aldosterone es- cape.
出处
《现代生物医学进展》
CAS
2015年第5期900-904,940,共6页
Progress in Modern Biomedicine
基金
上海市科技局基金项目(SHXH201139)
