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目的:探讨亚甲基四氢叶酸还原酶(MTHFR)基因多态性与青年原发性高血压(EH)患者冠状动脉 (冠脉)病变的关系。方法:利用分子灯塔技术检测79例青年EH患者的MTHFR基因型分布,冠脉造影了解冠脉病变情况,以冠脉造影阳性为Ⅰ组,冠脉造影阴性为Ⅱ组,分析年龄、病程、收缩压、舒张压、血糖、胆固醇、三酰甘油、吸烟史、饮酒史及MTHFR基因型在2组中的差别,以Logistic回归分析以上各因素与EH患者冠脉病变的相关性。结果:79例EH患者有25例冠脉造影结果异常(其中单支病变3例,双支病变8例,3支病变14例), 冠脉造影正常54例。基因型检测结果示TT 32(40．51％)、CT 34(43．04％)、CC 13(16．46％)符合Hardy-Weinbery定律。单因素分析Ⅰ组病程较Ⅱ组更长(P<0．05),Ⅰ组的TT基因型频率及T等位基因频率均高于Ⅱ组 (P<0．05),多因素Logistic回归分析也显示只有病程(OR=1．88,95％CI 1．28-2．77,P<0．01)和TT基因型(OR=4．37,95％CI 1．02-18．62,P<0．05)是青年EH患者发生冠脉病变的危险因素。结论:未经系统治疗的EH患者病程越长越易罹患冠心病,MTHFR基因多态性可能是青年EH患者发生冠脉病变的重要遗传学因素。
Objective: To investigate the relationship between methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and coronary artery disease (CHD) in young patients with essential hypertension (EH). Methods: The molecular beacon technique was used to detect the distribution of MTHFR gene in 79 young patients with EH. Coronary angiography was used to assess coronary artery disease. Coronary angiography was positive in group Ⅰ, negative in coronary angiography in group Ⅱ. Age, duration of disease, Pressure, diastolic blood pressure, blood glucose, cholesterol, triglyceride, smoking history, drinking history and MTHFR genotype in the two groups. Logistic regression analysis was used to analyze the correlation between these factors and coronary artery disease in EH patients. Results: Among 79 patients with EH, 25 cases had abnormal coronary angiography (including 3 cases of single vessel disease, 8 cases of double vessel disease and 14 cases of 3 vessel disease). Coronary angiography was normal in 54 cases. Genotypes showed that TT 32 (40.51%), CT 34 (43.04%) and CC 13 (16.46%) were in accordance with Hardy-Weinbery’s law. Univariate analysis showed that the duration of TT in group Ⅰ was longer than that in group Ⅱ (P <0.05). TT genotype frequency and T allele frequency in group Ⅰ were higher than those in group Ⅱ (P <0.05), and multivariate Logistic regression analysis Also showed that only the duration (OR = 1.88,95% CI 1.28-2.77, P <0.01) and TT genotype (OR = 4.37, 95% CI 1.02-18.62, P <0.05) is a risk factor for coronary artery disease in young EH patients. Conclusion: The longer the duration of EH patients without systemic treatment is more likely to suffer from coronary heart disease, the MTHFR gene polymorphism may be an important genetic factor in the occurrence of coronary artery disease in young EH patients.