摘要
目的:探讨高血压合并急性心肌梗死患者血管紧张素II受体1(AGTR1)A1166C基因多态性。方法:选取2024年1月—2024年8月某院原发性高血压患者99例,根据是否合并急性心肌梗死分为合并组(n=49)和高血压组(n=50);选取同期健康体检者50例为对照组,采用聚合酶链式反应(PCR)技术检测3组的AGTR1 A1166C基因分型。比较3组AGTR1 A1166C基因分布频率,合并组与高血压组不同高血压分级患者AGTR1 A1166C基因分布频率,合并组不同基因型患者血清血管紧张素转换酶(ACE)活性、心肌肌钙蛋白I(cTnI)峰值及左心射血分数(LVEF)、危重病例评分(SOFA)。结果:3组AA型基因分布频率:合并组>高血压组>对照组,差异有统计学意义(P<0.05);AC型、CC型基因分布频率比较差异无统计学意义(P>0.05)。合并组A等位基因分布频率高于高血压组和对照组,差异有统计学意义(P<0.05);3组C等位基因分布频率比较,差异无统计学意义(P>0.05)。1、2级高血压患者中,合并组AA型基因、A等位基因分布频率高于高血压组,差异有统计学意义(P<0.05);AC、CC型基因及C等位基因分布频率比较,差异无统计学意义(P>0.05)。3级高血压患者中,合并组AA、CC型基因及A等位基因分布频率低于高血压组,差异有统计学意义(P<0.05);AC型基因、C等位基因分布频率比较,差异无统计学意义(P>0.05)。合并组血清ACE活性、cTnI峰值水平:CC型基因>AC型基因>AA型基因;LVEF≤45%患者比例、SOFA评分:AA型基因>AC型基因>CC型基因,A等位基因>C等位基因,差异有统计学意义(P<0.05)。结论:高血压并发急性心肌梗死与AGTR1 A1166C基因多态性有关,携带A等位基因可能增加高血压患者并发急性心肌梗死的发生风险。高血压合并急性心肌梗死患者血清ACE活性和cTnI峰值升高与CC基因型相关;携带AA基因型患者更容易导致左心功能不全的发生。
Objective:To investigate the A1166C gene polymorphism of angiotensin II receptor 1(AGTR1)in patients with hypertension complicated with acute myocardial infarction.Methods:A total of 99 patients with essential hypertension who were hospitalized in a hospital from January 2024 to August 2024 were selected as subjects and were divided into a hypertension with acute myocardial infarction group(n=49)and a hypertension group(n=50).50 healthy individuals who underwent physical examinations during the same period were chosen as the control group.The genotyping of AGTR1 A1166C in the 3 groups was detected by polymerase chain reaction(PCR).The distribution frequency of AGTR1 A1166C gene in the 3 groups was compared.The distribution frequency of AGTR1 A1166C gene in patients with different hypertension grades in the combined group and the hypertensive group,the activity of serum angiotensin-converting enzyme(ACE),the peak value of cardiac troponin I(cTnI),the level of left ejection fraction(LVEF),and the Critical Case Assessment(SOFA)in patients with different genotypes in the combined group were compared.Results:The frequency distribution of AA genotypes in the the 3 groups:AA genotype in the combination group>hypertension group>control group,the difference being statistically significant(P<0.05);the frequency distribution of AC genotype and CC genotype among the 3 groups was not statistically significant(P>0.05).Among the 3 groups,the distribution frequency of alleles A in the combination group was significantly higher than that in the hypertension and control group,the difference being statistically significant(P<0.05),and there was no difference between the distribution frequency of allele C among the 3 groups(P>0.05).In comparison of AGTR1 A1166C gene distribution frequency between the combined group and the hypertension group,the distribution frequency of AA genotype and allele A of grade 1 and grade 2 hypertension patients in the combined group was higher than that in the hypertension group,the difference being statistically significant(P<0.05),and the distribution frequency of AC,CC and allele C was not statistically significant(P>0.05).In patients with grade 3 hypertension,the distribution frequencies of AA,CC and allele A in the combined group were lower than those in the hypertension group,the difference being statistically significant(P<0.05),and the distribution frequencies of AC and allele C were not significanly different(P>0.05).The serum ACE activity and cTnI peak levels in the combined group were CC genotype>AC genotype>AA genotype.As for the proportion of patients with LVEF≤45%and SOFA score:AA genotype>AC genotype>CC genotype,and allele A>allele C,the difference being statistically significant(P<0.05).Conclusion:AGTR1 A1166C gene polymorphism is associated with hypertension complicated with myocardial infarction,and carrying allele A may increase the risk of hypertension complicated with myocardial infarction.Increased serum ACE activity and cTnI peak levels were associated with CC genotype in patients with acute myocardial infarction,which has a higher risk of acute myocardial infarction.Left heart dysfunction is more likely to occur in patients carrying AA genotype.
作者
高磊
高顶
王茂松
胡飞
冯崴
GAO Lei;GAO Ding;WANG Maosong;HU Fei;FENG Wei(Department of Cardiovascular Medicine,The Second Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233000,China)
出处
《淮海医药》
2025年第3期221-226,共6页
Journal of Huaihai Medicine
基金
蚌埠医科大学校级重点科研课题项目(2022byzd089)。
作者简介
高磊(1985-),男,主治医师,硕士,博士在读;通讯作者:冯崴,E-mail:weiwei791107@.sina.com。
