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目的探讨高血压左心室肥厚(LVH)患者血管紧张素转换酶(ACE)基因和Chymase基因的多态性与心房颤动(AF)的相关性。方法选择2005年12月-2008年5月在福州总医院住院的881例原发性高血压合并LVH患者。纳入其中128例AF患者作为AF组,按年龄、性别、左心室体重指数等临床资料进行1∶2配比,选择256例窦性心律者作为对照组。运用聚合酶链反应检测ACE基因的I/D多态性,运用限制性片段长度多态性技术检测Chymase基因的CMA/B多态性。结果ACE基因的DD基因型和D等位基因在AF组和对照组间分布差异有统计学意义(分别为:χ2=11.020,P=0.004;χ2=9.327,P=0.002)。Logistic多元回归分析显示,与Ⅱ型纯合子相比,DD型纯合子使高血压LVH患者发生AF的风险增加2.6倍(OR=2.649,95%CI:1.47～5.31)。Chymase基因CMA/B多态位点的基因型及等位基因频率在AF组和对照组间分布差异无统计学意义。结论ACE基因I/D多态与高血压LVH患者AF的发生显著相关,DD基因型增加AF发生的风险。Chymase基因CMA/B多态与高血压LVH患者AF的发生无关。
Objective To investigate the association between angiotensin converting enzyme (ACE) gene and Chymase gene polymorphism and atrial fibrillation (AF) in patients with hypertensive left ventricular hypertrophy (LVH). Methods 881 patients with essential hypertension and LVH who were hospitalized in Fuzhou General Hospital from December 2005 to May 2008 were selected. A total of 128 patients with AF were enrolled as the AF group. According to the clinical data of age, gender, and body mass index of left ventricle, 1: 2 ratio was used. 256 patients with sinus rhythm were selected as the control group. The I / D polymorphism of ACE gene was detected by polymerase chain reaction and the CMA / B polymorphism of Chymase gene was detected by restriction fragment length polymorphism. Results There was significant difference in the distribution of DD genotypes and D allele between AF group and control group (χ2 = 11.020, P = 0.004; χ2 = 9.327, P = 0.002). Logistic multivariate regression analysis showed that DD homozygotes increased the risk of developing AF in patients with hypertensive LVH by 2.6-fold (OR = 2.649, 95% CI: 1.47-5.31) compared with those of type II homozygotes. Chymase gene CMA / B polymorphic loci genotypes and allele frequencies in the AF group and the control group, the distribution was not statistically significant. Conclusions ACE gene I / D polymorphism is significantly associated with AF in hypertensive patients with LVH, and DD genotype increases the risk of AF. Chymase gene CMA / B polymorphism and hypertension in patients with LVH AF has nothing to do.