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目的:探讨原发性高血压(EH)患者血管紧张素转化酶(ACE)基因I/D多态性与血管内皮损伤的相关性。方法:选择初次诊断的EH患者68例,采用聚合酶链反应(PCR)方法进行ACE基因分型,并测定其血浆可溶性P选择素(sP-selectin)、血栓烷B2(TxB2)和6-酮-前列腺素F1α(6-keto-PGF1α)浓度和血管假性血友病因子(v WF)抗原水平。结果:根据等位基因分布,EH患者分为DD型(18例)、ID型(26例)和II型(24例)3组;DD型的血浆sP-selectin、TxB2浓度和v WF抗原水平明显高于其他2型(P<0·05),而6-keto-PGF1α浓度则是DD型最低(P<0·05)。多因素Logistic回归分析显示ACE/DD基因型是引起患者血浆sP-selectin、TxB2、v WF升高和6-keto-PGF1α降低的独立危险因子。结论:ACE/DD基因型的EH患者较ACE/ID型和ACE/II型具有更为明显的血管内皮损伤倾向。
Objective: To investigate the relationship between angiotensin-converting enzyme (ACE) gene I / D polymorphism and vascular endothelial cell injury in patients with essential hypertension (EH). Methods: Sixty-eight EH patients diagnosed initially were enrolled in this study. ACE genotyping was performed by polymerase chain reaction (PCR) and their plasma levels of soluble P-selectin, TxB2 and 6-keto- - prostaglandin F1α (6-keto-PGF1α) and von Willebrand factor (v WF) antigen levels. Results: According to allele distribution, EH patients were divided into DD type (18 cases), ID type (26 cases) and type II (24 cases). The plasma levels of sP-selectin, TxB2 and vWF antigen Was significantly higher than the other type 2 (P <0.05), while the concentration of 6-keto-PGF1α was the lowest (P <0.05). Multivariate Logistic regression analysis showed that ACE / DD genotype was an independent risk factor for the increase of plasma sP-selectin, TxB2, v WF and the decrease of 6-keto-PGF1α in patients. CONCLUSION: EH patients with ACE / DD genotype have more pronounced endothelial damage than ACE / ID and ACE / II.