摘要
目的探讨亚甲基四氢叶酸还原酶(MTHFR) C677T基因多态性与阿托伐他汀钙降低H型高血压患者血浆同型半胱氨酸(Hcy)水平的相关性。方法 2016年1月至2017年10月在我院心内科住院或门诊就诊的H型高血压患者476例,按照随机数字表法,分为对照组(212例)和观察组(264例)。对照组患者接受常规降压治疗,观察组患者在常规降压治疗的基础上加服阿托伐他汀钙。采用PCR-RELP检测MTHFR C677T基因型及等位基因的分布频率,并分析不同基因型患者血浆Hcy水平的变化。结果观察组患者MTHFR C677T基因多态性分布频率为21.97%CC、47.73%CT、30.30%TT,对照组为23.11%CC、46.70%CT、30.19%TT。治疗前,两组TT型高血压患者血浆Hcy水平均明显高于CC型和CT型患者(P <0.05);治疗后,不同基因型患者平均血浆Hcy水平均降低(P <0.05);其中观察组TT型患者Hcy下降幅度大于CC型和CT型患者(P <0.05);而对照组3种基因型患者Hcy下降幅度基本一致(P> 0.05)。经二元Logistic回归分析,MTHFR C677T基因位点TT型突变是阿托伐他汀钙降低H型高血压患者血浆Hcy水平的重要影响因素(P <0.05)。结论 MTHFR C677T基因多态性与阿伐他汀钙降低H型高血压患者血浆Hcy水平密切相关。
Objective To investigate the correlation between the genotype polymorphisms of methylene tetrahydmfolate reductase(MTHFR) C677T gene and the effect of atorvastatin calcium on serum homocysteine(Hcy) in the treatment of patients with H-type hypertension disease.Methods Totally 476 patients with H-type hypertension disease in our hospital were enrolled in the study who were treated from January 2016 to October 2017, and they were divided into 2 groups.Control group(n=212) was treated with conventional antihypertensive drugs,and observation group(n=264) was treated with conventional antihypertensive drugs and atorvastatin calcium.The genotype and alleles of MTHFR C677T gene were analyzed by PCR-RELP, and the serum level of Hcy was detected.Results The frequency of MTHFR C677T gene polymorphism in observation group was 21.97% CC,47.73% CT and 30.30% TT,and that in control group was 23.11% CC, 46.70% CT and 30.19% TT.Before treatment, the serum level of Hcy in patients with TT type was higher than that with CC or CT type(P < 0.05).After treatment, the mean serum Hcy level of patients was lower than that before treatment(P < 0.05), and the △Hcy level of patients with TT type in observation group was higher than that in patients with CC or CT type(P < 0.05),while no significant difference was found in the△Hcy among the 3 genotypes in control group(P > 0.05).As the result of Logistic analysis,TT mutation of MTHFR C677T gene was the key influencing factor for the effect of atorvastatin calcium on serum Hcy in the treatment of patients with H-type hypertension disease(P < 0.05).Conclusion Atorvastatin calcium can significantly decrease the serum Hcy of H-type hypertension patients,which is associated with the MTHFR C677T TT genotype polymorphisms.
引文
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