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目的调查家族性高血压患者并发冠心病的风险因素。方法 185例家族性高血压病人分为91例未并发冠心病组,94例高血压并发冠心病组,135例体检人群作为对照组,进行对比研究。内皮型一氧化氮合酶(eNOS)基因894G→T位点多态性采用聚合酶链反应—限制性酶切片段长度多态性(PCR-RFLP)技术。血清NOx(-NO2-、NO3-)水平通过显色法测定。全自动生化分析仪检测血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、尿素氮、肌酐水平。各检测结果通过Logistic回归分析筛选高风险因素。结果对照组、高血压组、高血压并发冠心病组中T等位基因频率依次升高,三组间差异有统计学意义(χ2=13.32,P=0.001 3),但高血压并发冠心病组与高血压组差别不显著,而在男性人群中,两者T等位基因频率差异有统计学意义(χ2=7.84,P=0.005)。血清NOx-检测显示对照组、高血压组、高血压并发冠心病组依次为(50.5±28.7)、(62.5±30.1)、(105.0±31.2)μmol/L,三组间差异有统计学意义(F=96.297,P=0.000)。Logistic回归分析性别(P=0.036)、血清NOx(-P=0.017)、三酰甘油(P=0.018)、肌酐(P=0.046)、894T(P=0.017)被选入Logistic回归方程。结论性别、血清、三酰甘油、肌酐、NOx-、eNOS基因第7外显子894T等位基因均属高血压并发冠心病的风险因素。
Objective To investigate the risk factors of coronary heart disease in patients with familial hypertension. Methods 185 cases of familial hypertension were divided into 91 cases of non-concurrent coronary heart disease group, 94 cases of hypertension complicated with coronary heart disease group, 135 cases of physical examination population as a control group for comparative study. The 894G → T polymorphism of endothelial nitric oxide synthase (eNOS) gene was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Serum NOx (-NO2-, NO3-) levels were determined by colorimetry. Automatic biochemical analyzer for blood glucose, triglyceride, total cholesterol, high-density lipoprotein cholesterol, urea nitrogen, creatinine levels. Each test result was screened for high-risk factors by Logistic regression analysis. Results The frequency of T allele in control group, hypertension group and hypertension complicated with coronary heart disease group increased in turn, the difference was statistically significant among the three groups (χ2 = 13.32, P = 0.001 3), but the incidence of hypertension complicated with coronary heart disease The difference of T allele frequency between the two groups was statistically significant (χ2 = 7.84, P = 0.005). The levels of serum NO-2 in the control group, the hypertension group and the CHD group were (50.5 ± 28.7), (62.5 ± 30.1) and (105.0 ± 31.2) μmol / L, respectively, with significant difference F = 96.297, P = 0.000). Logistic regression analysis was used to analyze Logistic regression equation for gender (P = 0.036), serum NOX (-P = 0.017), triglyceride (P = 0.018), creatinine (P = 0.046), and 894T (P = 0.017). Conclusions Gender, serum triglyceride, creatinine, NOx- and eNOS gene exon 7 of 894T allele are both risk factors of hypertension with coronary heart disease.