冠心病血瘀证与血管紧张素转换酶基因多态性和内皮型一氧化氮合成酶基因G894T变异的关系

目的探讨冠状动脉粥样硬化性心脏病(冠心病)血瘀证与血管紧张素转换酶(angio-tensin converting enzyme,ACE)基因多态性和内皮型一氧化氮合成酶(endothelial nitric oxide synthase,eNOS)基因G894T变异的关系。方法对160例冠心病患者进入临床试验,均经冠状动脉造影诊断,分为血瘀证119例和非血瘀证组41例。用PCR方法测定ACE基因多态性和eNOS基因G894T变异,比较其基因频率。结果 (1)冠心病血瘀证组与非血瘀证组ACE基因频率分布:血瘀证组DD型有49例,占41.18%;I/D型有42例,占35.29%;II型有28例,占23.53%。非血瘀证组DD型有18例,占43.90%;I/D型有14例,占34.15%;II型有9例,占21.95%。两组基因频率分布无差异(P>0.05);(2)冠心病血瘀证组与非血瘀证组eNOS基因频率分布:血瘀证组GG型有58例,占48.74%;GT型有33例,占27.73%;TT型有28例,占23.53%。非血瘀证组GG型有17例,占41.46%;GT型有14例,占34.15%;TT型有10例,占24.39%。两组基因频率分布无差异(P>0.05)。(3)冠心病血瘀证血管狭窄支数与ACE基因型分布的关系,血管狭窄数大于等于3支有46人,DD型有20例,I/D型有16例,II型10例。二者具有相关性(P<0.05)。(4)冠心病血瘀证支架数与ACE基因型分布的关系,支架数大于等于3个有19人,DD型有11例,I/D型有6例,II型2例。二者具有相关性(P<0.01)。结论 (1)冠心病血瘀证与ACE基因多态性、eNOS基因变异无明显的相关性;(2)冠心病血瘀证患者ACE基因DD、I/D型者病情严重程度较II型高,存在多支病变。

Study of correlation between the blood stasis syndrome of coronary heart disease and angiotension converting enzyme （ACE）gene polymorphism and variant of endothelial nitric oxide synthase （eNOS） gene（Glu298Asp）

Objective To discover the correlation between the blood stasis syndrome of coronary heart disease and angiotension converting enzyme gene polymorphism and variant of endothelial nitric oxide synthase（eNOS） gene （Glu298Asp）. Methods Observing 160 Guangdong natives of coronary heart disease,ll9 cases of syndrome of coronary heart disease,41 cases no-syndrome of blood stasis of coronary heart disease and collecting 2 ml blood from every subject and extracting DNA, with the method of PCR to detect angiotension converting enzyme gene polymorphism and variant of endothelial nitric oxide synthase gene, We compare the frequencies of the ACE gene and eNOS gene between the group of blood stasis syndrome of coronary heart disease and group of no-syndrome blood stasis of coronary heart disease. Results （ 1 ） The distribution of gene frequencies between group of syndrome of coronary heart disease and group of no-syndrome of coronary heart disease：in the group of blood stasis of syndrome of coronary heart disease： the amount and frequencies of ACE DD,I/D and I1 were 49 cases （41.18%） ,42 cases （35.29%） ,28 cases （23.53%）. In the group of no-syndrome of blood stasis of coronary heart disease：the amount and fre- quencies of ACE DD,I/D and II were 18cases （43.90%） ,14 cases （34.15%） ,9 cases （21.95%）. There is no difference between the distribution of ACE genotype of both group（P 〉0.05）. （2） The distribution of gene frequencies between group of syndrome of coronary heart disease and group of no-syndrome of coronary heart disease：in the group blood stasis of syndrome of coronary heart disease：the amount and frequencies of eNOS GG,GT and Tr were 58 cases （48.74%） ,33 cases （27.73%） ,28 cases（23.53% ）. In the group of no-syndrome of blood stasis of coronary heart disease：the amount and frequency of eNOS GG,GT and Tr were 17cases （41.46%）, 14 cases （34.15%）, 10cases （24.39%）. There is no difference between the distribution of eNOS allele frequencies of both group （ P 〉 0.05 ）. （3） There is evidence of any correlation between the number of angiostenosis of the blood stasis syndrome of CHD and the distribution of ACE genotype： the number of angiostenosis was equal or greater than 3 were 46 people, DD （20） ,I/D（16）, II （10）（ P 〈 0.05 ）. （4） There is evidence of any correlation between the number of stents of the blood stasis syndrome of CHD and the distribution of ACE genotype ： the number of stents was equal or greater than 3 were 19people, DD（ll）,I/D（6）,II（2）（P〈 0.01）. Conclusion （1） Thereis no evidence of any correlation between the blood stasis syndrome of coronary heart diease and ACE gene Polymorphism and variant of eNOS gene. （2） The DD and I/D of ACE gene was more serious than II in the blood stasis syndrome of CHD patients, and there were more vascular diseases.