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目的探讨老年人功能性肠道障碍(FBD)患者的chymase(CMA)基因B种A/G多态性分布的特点,分析其合并血压增高、心脏结构异常、肾功能减退等靶器官损害的临床意义。方法选择89例老年FBD患者,按其在功能性胃肠病罗马Ⅱ标准中分型,所有患者按序数分成4个亚组包括肠易激综合征(C1;n=17)、功能性腹胀(C2;n=22)、功能性便秘(C3;n=27)、功能性腹泻(C4;n=23),并选择无FBD老年患者作为对照组(C;n=22),采用顺序特异性引物聚合酶链反应技术,检测各组患者循环血CMA基因B种A/G多态性的频率,将入选FBD病例分为纯合子GG基因型组(n=51),以及含A等位基因型纯合子AA和杂合子AG组(n=38),并进行两组的临床指标比较分析。结果FBD总组的CMA基因GG基因型、G等位基因频率为57.30%、76.40%,高于对照组的54.55%、75%,但无统计学意义(Ρ>0.05),FBD GG基因型组BMI、Cr、SBP、DBP、UAE、LVD、IVSD、LVPWD、LVMI等临床指标明显高于AA和AG基因型组(Ρ<0.05)。FBD四个组1～3级高血压总罹患率为84.26%(75/89),与对照组(59.09%;13/22)相差显著(P<0.01),C1组、C2组、C3组、C4组罹患高血压1～3级分别为70.59%(12/17)、95.45%(21/22)、92.59%(25/27)、73.91%(17/23),高于对照组59.09%(13/22)。C2组罹患高血压1～3级与对照组相比相差显著(P<0.01)。结论循环血CMA基因B种A/G多态性虽与老年人FBD患者相关不显著,但CMA基因GG基因型与老年人FBD合并血压增高、肾功能减退、心脏结构异常等靶器官损害相关。
Objective To investigate the distribution of B / A polymorphism of chymase (CMA) gene in elderly patients with functional bowel disorder (FBD) and to analyze its association with target organ damage such as increased blood pressure, abnormal cardiac structure and renal dysfunction significance. Methods Eighty-nine elderly patients with FBD were selected and classified according to the Rome II criteria for functional gastrointestinal disease. All patients were divided into 4 subgroups according to the ordinal number, including irritable bowel syndrome (C1; n = 17), functional bloating C2; n = 22), functional constipation (C3; n = 27), functional diarrhea (C4; n = 23), and elderly patients without FBD as controls (C; n = 22) The frequency of A / G polymorphism of B-CMA gene in each group was detected by primer polymerase chain reaction (PCR). The selected FBD cases were divided into homozygous GG genotype group (n = 51) and A allele Type homozygous AA and heterozygous AG group (n = 38), and compared the clinical indicators of the two groups. Results The frequencies of GG genotypes and G alleles of CMA gene in FBD group were 57.30% and 76.40%, respectively, which were higher than those in control group (54.55% and 75%, respectively) but not in FBD GG genotype group The clinical indexes of BMI, Cr, SBP, DBP, UAE, LVD, IVSD, LVPWD and LVMI were significantly higher than those of AA and AG genotypes (P <0.05). The overall prevalence of grade 1-3 hypertension among the four FBD groups was 84.26% (75/89), significantly different from that in the control group (59.09%; 13/22) (P <0.01) The level of hypertension in group C4 were 70.59% (12/17), 95.45% (21/22), 92.59% (25/27) and 73.91% (17/23), respectively, higher than that in control group (59.09%) 13/22). There was a significant difference between groups 1 and 3 of hypertension in control group (P <0.01). Conclusions Although the B / C polymorphism of CMA gene in circulating blood is not significantly correlated with FBD in the elderly, the GG genotype of CMA is associated with increased FBP, renal dysfunction and abnormal cardiac structure in the elderly.