内皮素受体A基因多态性与中青年急性冠脉综合征的相关性研究
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摘要
目的:探讨陕西地区汉族中青年人群中内皮素受体A(EDNRA)基因多态性与急性冠脉综合征(ACS)易感性的关系。方法:选择2014-01—2017-12期间在本院治疗的233例ACS患者纳入研究,分为ST段抬高型心肌梗死组(STEMI组,67例)、非ST段抬高型心肌梗死组(NSTEMI组,76例)和不稳定型心绞痛组(UAP组,90例),另外选择120例健康志愿者作为对照组。采用聚合酶链反应-限制性片段长度多态性法检测EDNRA基因rs1801708和rs5335位点多态性。结果:rs5335位点基因多态性在共显性基因模型、显性基因模型和等位基因模型下与NSTEMI和UAP发病风险相关,与STEMI发病风险无关。rs1801708位点基因多态性与STEMI、NSTEMI和UAP发病风险均差异无统计学意义(均P>0.05)。多因素分析结果显示携带EDNRA基因rs5335位点C等位基因可降低中青年人群NSTEMI和UAP的发生风险(OR=0.488,95%CI:0.361～0.834,P=0.017;OR=0.515,95%CI:0.366～0.910,P=0.013)。结论:EDNRA基因rs5335位点多态性与陕西地区汉族中青年人群ACS发生相关。
Objective:To investigate the genetic association between endothelin receptor type A(EDNRA)gene polymorphism and acute coronary syndrom(ACS)in young and middle aged population in the Han descent population in Shaanxi province.Method:233 ACS patients from January 2014 to December 2017 were recruited to participate in the study.They were divided into STEMI group(67 cases),NSTEMI group(76 cases)and UAP group(90 cases).And 120 healthy volunteers without ACS were chosen as control group.Genotype was determined by polymerase chain reaction combined with DNA direct sequencing technique for the polymorphism of rs1801708 and rs5335 in the EDNRA gene.Result:EDNRA gene rs5335 has significant associations with the risk of NSTEMI and UAP under co-dominant gene model,dominant gene model and allele model(all P<0.05).However,no significant association was found between rs5335 and the risk of STEMI(all P>0.05).While rs1801708 has no association with the risk of STEMI,NSTEMI and UAP.Multivariate Logistic regression analysis showed that allele C was protective factor of NSTEMI and UAP for young and middle aged population(OR =0.488,95%CI:0.361～0.834,P=0.017;OR=0.515,95%CI:0.366～0.910,P=0.013).Conclusion:EDNRA gene rs5335 polymorphism may closely related to ACS for young and middle aged population in the Han descent population in Shaanxi province.
Objective:To investigate the genetic association between endothelin receptor type A(EDNRA)gene polymorphism and acute coronary syndrom(ACS)in young and middle aged population in the Han descent population in Shaanxi province.Method:233 ACS patients from January 2014 to December 2017 were recruited to participate in the study.They were divided into STEMI group(67 cases),NSTEMI group(76 cases)and UAP group(90 cases).And 120 healthy volunteers without ACS were chosen as control group.Genotype was determined by polymerase chain reaction combined with DNA direct sequencing technique for the polymorphism of rs1801708 and rs5335 in the EDNRA gene.Result:EDNRA gene rs5335 has significant associations with the risk of NSTEMI and UAP under co-dominant gene model,dominant gene model and allele model(all P<0.05).However,no significant association was found between rs5335 and the risk of STEMI(all P>0.05).While rs1801708 has no association with the risk of STEMI,NSTEMI and UAP.Multivariate Logistic regression analysis showed that allele C was protective factor of NSTEMI and UAP for young and middle aged population(OR =0.488,95%CI:0.361～0.834,P=0.017;OR=0.515,95%CI:0.366～0.910,P=0.013).Conclusion:EDNRA gene rs5335 polymorphism may closely related to ACS for young and middle aged population in the Han descent population in Shaanxi province.
引文
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[17]Yammine L,Frazier L,Padhye NS,et al.Severe Depressive Symptoms are Associated with Elevated Endothelin-1in Younger Patients with Acute Coronary Syndrome[J].J Psychosom Res,2014,77(5):430-434.
[18]Lin YJ,Juan CC,Kwok CF,et al.Endothelin-1exacerbates development of hypertension and atherosclerosis in modest insulin resistant syndrome[J].Biochem Biophys Res Commun,2015,460(3):497-503.
[19]杨伟宪,杨铮,窦克非,等.217例青年冠心病患者临床特点分析[J].中国循环杂志,2014,29(5):339-342.
[20]张锦,刘铭,王恒大.急性冠脉综合征患者血浆内皮素及外周血单个核细胞内皮素受体mRNA检测[J].郑州大学学报(医学版),2007,42(5):901-904.
[21]朱峰,张鹏,宋建荣,等.EDNRA基因rs5335多态性与aSAH后迟发性脑血管痉挛的关联性研究[J].现代检验医学杂志,2017,32(6):56-59.
[2]Redfern J,Hyun K,Chew DP,et al.Prescription of secondary prevention medications,lifestyle advice,and referral to rehabilitation among acute coronary syndrome inpatients:results from a large prospective audit in Australia and New Zealand[J].Heart,2014,100(16):1281-1288.
[3]Silbiger VN,Luchessi AD,Hirata RD,et al.Novel genes detected by transcriptional profiling from whole-blood cells in patients with early onset of acute coronary syndrome[J].Clin Chim Acta,2013,421(4546):184-190.
[4]郝问,缪黄泰,王晓,等.40岁以下不同性别青年急性心肌梗死患者的临床特点及院内和远期预后分析[J].中国循环杂志,2016,31(10):976-980.
[5]Kilickesmez KO,Bing9l G,Bulut L,et al.Relationship between serum endothelin-1level and spontaneous reperfusion in patients with acute myocardial infarction[J].Coron Artery Dis,2015,26(1):37-41.
[6]Falk M,Huhn R,Behmenburg F,et al.Biomechanical stress in myocardial infarctions:can endothelin-1and growth differentiation factor 15serve as immunohistochemical markers?[J].Int J Legal Med,2018,132(2):509-518.
[7]徐晓蓉,李奎宝,王攀,等.阿托伐他汀对急性ST段抬高型心肌梗死患者血浆内皮素及血小板功能的影响[J].中华内科杂志,2016,55(12):932-936.
[8]刘丽,黄旭升,蔡艺灵,等.内皮素受体A基因多态性与散发性颅内动脉瘤的相关性[J].南方医科大学学报,2014,34(1):60-64.
[9]Kosior-Jarecka E,Wróbel-Dudzińska D,ukasik U,et al.Plasma endothelin-1and single nucleotide polymorphisms of endothelin-1and endothelin type A receptor genes as risk factors for normal tension glaucoma[J].Mol Vis,2016,22:1256-1266.
[10]房雅楠,隋汝波.EDNRA和EDNRB基因单核苷酸位点多态性与缺血性脑卒中的相关性[J].中国老年学,2016,36(18):4446-4449.
[11]Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology(ESC),Steg PG,James SK,et al.ESC Guidelines for the management of acute myocardial infarction in patients presenting with St-segment elevation[J].Eur Heart J,2012,33(20):2569-2619.
[12]Wright RS,Anderson JL,Adams CD,et al.2011AC-CF/AHA focused update incorporated into the ACC/AHA 2007Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in collaboration with the American Academy of Family Physicians,Society for Cardiovascular Angiography and Interventions,and the Society of Thoracic Surgeons[J].J Am Coll Cardiol,2011,57(19):e215-367.
[13]Magnoni M,Berteotti M,Ceriotti F,et al.Serum uric acid on admission predicts in-hospital mortality in patients with acute coronary syndrome.[J].Int J Cardiol,2017,240(1):25-29.
[14]Ozturk M,Askn L,Ipek E,et al.The Role of Serum Bilirubin Levels in Predicting Troponin Positivity in Non-ST-Segment Elevation Acute Coronary Syndrome[J].Am J Cardiol,2016,117(5):S9-S9.
[15]Li MN,Wang HJ,Zhang NR,et al.MTHFR C677Tgene polymorphism and the severity of coronary lesions in acute coronary syndrome[J].Medicine,2017,96(49):e9044.
[16]Xiao FY,Liu M,Chen BL,et al.Effects of four novel genetic polymorphisms on clopidogrel efficacy in Chinese acute coronary syndromes patients[J].Gene,2017,623(1):63-71.
[17]Yammine L,Frazier L,Padhye NS,et al.Severe Depressive Symptoms are Associated with Elevated Endothelin-1in Younger Patients with Acute Coronary Syndrome[J].J Psychosom Res,2014,77(5):430-434.
[18]Lin YJ,Juan CC,Kwok CF,et al.Endothelin-1exacerbates development of hypertension and atherosclerosis in modest insulin resistant syndrome[J].Biochem Biophys Res Commun,2015,460(3):497-503.
[19]杨伟宪,杨铮,窦克非,等.217例青年冠心病患者临床特点分析[J].中国循环杂志,2014,29(5):339-342.
[20]张锦,刘铭,王恒大.急性冠脉综合征患者血浆内皮素及外周血单个核细胞内皮素受体mRNA检测[J].郑州大学学报(医学版),2007,42(5):901-904.
[21]朱峰,张鹏,宋建荣,等.EDNRA基因rs5335多态性与aSAH后迟发性脑血管痉挛的关联性研究[J].现代检验医学杂志,2017,32(6):56-59.