摘要
目的分析探讨CYP11B2基因-344C/T多态性在原发性高血压患者中的分布情况及其在早期肾损害中的意义。方法选取笔者所在医院2014年2月—2017年2月收治的420例原发性高血压患者,根据患者的尿微量白蛋白与尿肌酐的比值将所有患者分为甲、乙两组,其中甲组患者均为高血压合并早期肾损害患者,而乙组患者则为高血压不合并早期肾损害患者,甲组患者183例,乙组患者237例。观察并比较两组患者的血浆醛固酮、血糖、血脂等水平,并用Taqman探针法对患者进行基因分型。结果两组患者之间的年龄和性别无明显差异(均P>0.05);甲组患者的高血压病程、收缩压、舒张压、尿微量白蛋白、血浆醛固酮等均显著高于乙组患者(均P<0.05)。各样本的DNA都能够明确其基因型,并且均符合Hardy-Weinberg平衡。甲组患者的TT基因型频率为57.92%,显著高于乙组患者的45.57%(χ^2=6.384,P<0.05);甲组患者的CC基因型频率为5.46%,显著低于乙组患者的10.55%(χ^2=6.927,P<0.05);甲组患者的T等位基因频率为87.43%,显著高于乙组患者的58.86%(χ^2=7.236,P<0.05)。各基因型之间的收缩压和舒张压以及血浆醛固醇水平具有显著差异(均P<0.05);各基因型之间的年龄、性别、高密度脂蛋白、低密度脂蛋白、空腹血糖以及C反应蛋白水平等之间差异不具有统计学意义(均P>0.05)。以高血压病程、基因型、收缩压、舒张压等作为自变量,以尿微量白蛋白和尿肌酐的比值作为因变量,采用加性模型进行Logistic回归分析,结果显示尿微量白蛋白和尿肌酐的比值与患者的收缩压具有明显的相关性(OR=1.032,95%CI:1.022~1.052,P<0.05),是高血压早期肾损害的独立危险因素之一;尿微量白蛋白和尿肌酐的比值与患者的高血压病程、舒张压以及基因多态性等无明显相关关系(均P>0.05)。结论 CYP11B2基因-344C/T多态性和原发性高血压患者出现早期肾损害密切相关,其
Objective To analyze the distribution of CYP11B2 gene -344C/T polymorphism in patients with primary hypertension and their significance in early renal injury. Methods The 420 patients with primary hypertension admitted in author's hospital from February 2014 to February 2017 were enrolled,according to their urine and urine trace albumin creatinine ratio divided into groups A and B(respectively 183 cases,237 cases):the patients of group A were with early renal damage,while the patients of group B not emerged with early renal damage. The plasma aldosterone,blood glucose and blood lipid levels of the two groups were observed and compared with norms Taqman probe method. Results There was no significant difference in the age and gender between the two groups(all,P>0.05);Hypertensive disease,systolic blood pressure,diastolic blood pressure,urinary microalbumin and plasma aldosterone were significantly higher in group A than in group B(all,P<0.05). The DNA of each sample was able to be identified the genotype and was consistent with the Hardy-Weinberg balance. The TT genotype frequency of the patients in group A was 57.92%,significantly higher than that of the patients in group B(χ^2= 6.384,P<0.05). The CC genotype frequency of the patients in group A was 5.46%,significantly lower than 10.55% in group B(χ^2=6.927,P<0.05). The frequency of T allele in group A was 87.43%,significantly higher than that in group B(χ^2=7.236,P<0.05). The systolic and diastolic blood pressure and plasma aldosterol levels were significantly different between the genotypes(P<0.05). Differences in age,sex,HDL,low density lipoprotein,fasting blood glucose,and C-reactive protein levels among the genotypes were not statistically significant(both P>0.05). Take hypertension course,genotype,systolic pressure,diastolic blood pressure as the independent variables,such as urine and urine trace albumin creatinine ratio as the dependent variable,additive model is adopted to improve the Logistic regression analysis,then the obtained results showed microa
作者
王智
WANG Zhi(No. 2 Area of the 3rd Health Care Dept.,the 960th Hospital of PLA,Jinan,Shandong 250031,China)
出处
《实用医药杂志》
2019年第8期685-688,共4页
Practical Journal of Medicine & Pharmacy
关键词
高血压
肾损害
多态性
醛固酮合酶
Hypertension
Renal damage
Polymorphism
Aldosterone synthase
