摘要
目的 探讨新疆维吾尔族人群基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）基因多态性与急性冠脉综合征（acute coronary syndrome,ACS）的相关性.方法 采用病例对照研究,选择2006年1月至2009年12月在新疆医科大学第一附属医院心脏中心住院并行冠状动脉造影检查证实的维吾尔族急性冠脉综合征患者352例（包括不稳定型心绞痛213例、急性心肌梗死139例）和同期入院冠状动脉造影检查阴性的对照组421例.采用聚合酶链反应-限制性片段长度多态性技术对所有纳入对象的MMP-9基因-1562C＞T和R279Q多态性进行分析,并结合造影情况,探讨MMP-9基因多态性与ACS发生及冠脉狭窄程度的关系.用Hardv-Weinberg平衡检验样本群体代表性;各组基因型和等位基因频率差异比较采用x2检验,并以优势比（OR）及其95%可信区间（95%CI）表示相对的风险度;综合评价各因素与ACS相关性采用多因素Logistic回归分析;以P＜0.05为差异具有统计学意义.结果 MMP-9基因-1562C＞T多态性位点ACS组CT＋TT基因型和T等位基因频率（25.9%,14.5%）显著高于对照组（15.7%,8.4%）,差异有统计学意义（P＜0.01）.R279Q位点ACS组和对照组RQ＋QQ基因型和Q等位基因频率分别为67.0%,45.6%,64.6%,42.0%,两组比较差异无统计学意义（P＞0.05）.多因素Logistic回归分析显示-1562T等位基因是ACS发生的独立风险因素（P＜0.05）.不同冠脉病变支数亚组中CT＋TT基因型和CC基因型的分布比较差异无统计学意义（P＞0.05）.结论 MMP-9基因1562C＞T多态性与新疆维吾尔族人群ACS的发生可能相关,T等位基因可能是ACS遗传易感性的基因标记之一,-1562C＞T基因多态性与ACS冠脉狭窄程度无关,R279Q基因多态性与维吾尔族人群ACS发生未见明显相关.
Objective To investigate the association between matrix metalloproteinase-9 （MMP-9） gene polymorphism （-1562C 〉 T/R279Q） and acute coronary syndrome （ACS） in Uygur nationality of Xinjiang Autonomous Region of China. Methods A total of 352 patients with ACS including 213 patients with unstable angina pectoris and 139 patients with acute myocardial infarction evidenced by using coronary arteriography and 421 control subjects were recruited in this study. The MMP-9-1562C 〉 T and R279Q genotypes were detemined by using PCR-RFLP method. The relationship between the polymorphism in the MMP-9 gene and the severity of coronary arterial stenosis was analyzed. All polymorphisms were determined for confimation with Hardy-Weinberg expectations in both groups separately. Differences in distributions of genotypes and alleles between two groups were analyzed with x2 test. The association between the MMP-9 polymorphisms and the risk of ACS was estimated by odds ratio（Ors） and their 95% confidence intervals （CIs）, and the comprehensive evaluation of the factors associated with ACS was determined by using multifactor logistic regression. P 〈 0. 05 was considered to be statistically significant. Results The genotype frequencies for CT ＋ TT genotypes and T allele were 25.9 and14.5 percent in ACS subjects and 15.7 and 8.4 percent in control subjects, respectively. The genotype frequencies were different significantly between the two groups （x2 = 12.26,P 〈 0.01;x2 = 14.15,P 〈 0.01, respectively）. No relationship between R279Q polymorphism and ACS was found in this study （ P 〉 0.05）. The multifactor logistic regression analysis showed that the T allele carrier （CT ＋ TT） significantly increased the risk of ACS compared with the CC genotype （ OR = 1.791,95 % CI： 1. 088 - 2.951, P = 0.022） after adjustment for tradition risk factors. The frequencies for CT ＋ TT and CC genotypes of the -1562C 〉 T polymorphism were not statistically different among ACS patients with one, two and three or more significantly diseased vessels （ x2 = 1.15, P = 0.56）. Conclusions The findings suggest that the polymorphism in MMP-9 gene promoter （-1562C 〉 T） is associated with the susceptibility to the ACS. The T allele might be an independent risk factor for the ACS. But the -1562C 〉 T polymorphism may not be useful as a predictor of the severity of coronary arterial stenosis. The R279Q polymorphism of MMP-9 gene was not significantly associated with ACS in this studied population.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2010年第11期1146-1150,共5页
Chinese Journal of Emergency Medicine
基金
新疆维吾尔自治区重大专项课题（200733146-3）
