山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (2): 10-20.doi: 10.6040/j.issn.1671-7554.0.2024.0517
侯晓慧,Arezou Bikdeli,马超,李大庆
HOU Xiaohui, AREZOU Bikdeli, MA Chao, LI Daqing
摘要: 目的 探讨ACE插入(insertion, I)/缺失(deletion, D)、激肽释放酶基因(kallilrein gene, KLK)1(rs5517)、前列环素合成酶基因(prostacyclin synthase gene, PTGIS)(rs5629)基因位点多态性与250例非ST段抬高型急性冠状动脉综合征(non ST segment elevation acute coronary syndrome, NSTE-ACS)患者易感性及冠状动脉病变程度的关联。 方法 收集200例冠心病患者和50例同周期冠状动脉正常者的临床资料并分别通过PCR和Sanger测序进行基因分型。采用病例-对照分组,通过二分类Logistic回归分析与NSTE-ACS有关联的3个基因型及相互联合基因型的易感性。以Gensini评分和SYNTAX评分表示冠状动脉病变严重程度,采用多元线性回归分析相互联合基因型与冠状动脉病变严重程度的关联性。 结果 二元Logistic回归分析中,在调整年龄、LDL、同型半胱氨酸等混杂因素后,与NSTE-ACS危险性有关联的基因型为:ACE DD(OR=4.335,95%CI:1.105~17.016,P=0.036)、KLK1 CC(OR=3.152,95%CI:1.077~9.230,P=0.036)、KLK1 TT & PTGIS TT(OR=0.065,95%CI:0.006~0.752,P=0.029);多元线性回归分析中,与Gensini评分有关联的联合基因型为ACE DD & KLK1 CC(β=51.847,P=0.001),与SYNTAX评分有关联的联合基因型为ACE DD & KLK1 CC(β=10.031,P=0.001)。 结论 ACE I/D基因型和KLK1(rs5517)基因型与NSTE-ACS有关联,ACE DD基因型和KLK1 CC基因型增加NSTE-ACS的危险性;KLK1 TT & PTGIS TT亚型可能降低山东籍汉族人NSTE-ACS患病的危险性;ACE DD & KLK1 CC亚型与冠状动脉病变严重程度呈正向关联。
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