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目的探讨血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性及血管紧张素原(AGT)基因M235T多态性与高血压左室肥厚(LVH)的关系。方法对68例超声心动图诊断的未接受治疗的高血压合并LVH患者与76例高血压非LVH患者进行病例对照研究。采用聚合酶链式反应(PCR)与限制性片段长度多态性(RFLP)技术检测ACE基因I/D多态性及AGT基因M235T变异。以二维引导的M型超声心动图测量并计算左室重量。结果①该组高血压患者ACE与AGT基因型的分布均符合Hardy Weinberg平衡。②ACE基因I/D基因型在LVH组与非LVH组的分布差异有显著性(χ2=6.777,P<0.05)。LVH组DD基因型与D等位基因的频率均高于非LVH组(DD基因型:0.31vs0.13,χ2=6.674,P=0.01;D等位基因:0.54vs0.41,χ2=4.837,P<0.05)。③AGT基因M235T基因型在LVH组与非LVH组的分布差异有显著性(χ2=7.133,P<0.05)。LVH组TT基因型与T235等位基因的频率均高于非LVH组(TT基因型:0.62vs0.40,χ2=7.133,P<0.01;T235等位基因:0.78vs0.65,χ2=5.741,P<0.05)。④联合基因分析显示,LVH组ACE DD+AGT TT基因型频率显著高于非LVH组(0.22vs0.05,χ2=8.839,P<0.01),具有该联合基因型者发生LVH的风险比数比(OR=5.094)明显高于单独具有ACE DD基因型(OR=2.949)或AGT TT基因型(OR=2.477)者。结论ACE?
Objective To investigate the relationship between angiotensin converting enzyme (ACE) gene insertion / deletion (I / D) polymorphism and angiotensinogen (AGT) gene M235T polymorphism and hypertension with left ventricular hypertrophy (LVH). Methods 68 cases of echocardiographic diagnosis of untreated hypertensive patients with LVH and 76 cases of hypertensive non-LVH patients were case-control study. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) were used to detect ACE gene I / D polymorphism and AGT gene M235T mutation. Left ventricular mass was measured and calculated using two-dimensional guided M-mode echocardiography. Results ① The distribution of ACE and AGT genotypes in this group of hypertensive patients were in accordance with the Hardy Weinberg equilibrium. ② The distribution of ACE gene I / D genotype in LVH group and non-LVH group was significantly different (χ2 = 6.777, P <0.05). The frequencies of DD genotype and D allele in LVH group were higher than those in non-LVH group (DD genotype: 0.31 vs 0.13, χ2 = 6.674, P = 0.01; D allele: 0.54 vs 0.41, χ2 = 4.837, P <0.05). (3) There was a significant difference in the distribution of AGT gene M235T between LVH group and non-LVH group (χ2 = 7.133, P <0.05). The frequencies of TT genotype and T235 allele in LVH group were higher than those in non-LVH group (TT genotype: 0.62vs0.40, χ2 = 7.133, P <0.01; T235 allele: 0.78vs0.65, χ2 = 5.741, P <0.05). ④The combined gene analysis showed that the frequency of ACE DD + AGT TT genotype in LVH group was significantly higher than that in non-LVH group (0.22vs0.05, χ2 = 8.839, P <0.01). The risk odds ratio of LVH in this combined genotype (OR = 5.094) were significantly higher than those with ACE DD genotype alone (OR = 2.949) or AGT TT genotype (OR = 2.477). Conclusion ACE?