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目的:探讨血管紧张素转换酶(ACE)基因插入/缺失(I/D)和醛固酮合成酶(CYP11B2)基因-344T/C多态性与高血压病中风先兆证(EH-PAS)的相关性。方法:用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法,检测EH-PAS患者和与之1∶1相匹配(按性别、年龄±3岁、居住地)的无中风先兆的高血压组(EH-non-PAS组)、对照组(Control)各116例的CYP11B2-344T/C基因型,用PCR法检测ACE(I/D)基因型。结果:χ2分割后EH-PAS组ACE-DD型频率(25.00%)显著高于EH-non-PAS组(13.79%)和Control组(12.93%)(χ2=7.341,P=0.007),基因联合分析DD+TC/CC型频率分布(13.79%)高于EH-non-PAS组(3.45%)和Control组(3.45%)(χ2=12.889,P<0.001)。多因素Logistic回归调整混杂因素后,以EH-non-PAS组为参照系,DD型患EH-PAS的OR值为2.303(95%CI,1.130～4.694,P=0.022),以II/ID+TT型为参比基线,DD+TC/CC型OR值为4.519(95%CI,1.368～14.928,P=0.013),OR值最大。结论:携带ACE-DD型与ACE-DD+CYP-TC/CC基因型与EH-PAS有关联,两种基因在EH-PAS发病中有协同作用。
Objective: To investigate the relationship between angiotensin converting enzyme (ACE) gene insertion / deletion (I / D) and aldosterone synthase (CYP11B2) gene -344T / C polymorphism and hypertension with stroke precursor syndrome (EH-PAS) . Methods: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect stroke-free patients with EH-PAS matched with 1: 1 (sex, age ± 3 years, place of residence) The genotypes of ACE (I / D) were detected by polymerase chain reaction in CYP11B2-344T / C genotypes in 116 cases of EH-non-PAS group and control group. Results: The frequency of ACE-DD in EH-PAS group was significantly higher than that in EH-non-PAS group (13.79% vs 12.93%, χ2 = 7.341, P = 0.007) The frequency distribution of DD + TC / CC type (13.79%) was higher than that of EH-non-PAS group (3.45%) and Control group (3.45%) (χ2 = 12.889, P <0.001). In the EH-non-PAS group, the OR of EH-PAS patients with DD type was 2.303 (95% CI, 1.130-4.694, P = 0.022) after adjusting for confounding factors by multivariate Logistic regression. The TT type was the reference baseline. The OR of DD + TC / CC type was 4.519 (95% CI, 1.368-14.928, P = 0.013) with the highest OR value. CONCLUSION: The association of ACE-DD and ACE-DD + CYP-TC / CC genotypes with EH-PAS carries a synergistic effect in the pathogenesis of EH-PAS.