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目的探讨高血压左心室肥厚(LVH)患者p22phox基因C242T和-930A/G位点多态性与发生心房颤动(AF)的相关性。方法选择881例原发性高血压合并LVH患者,纳入其中128例合并心房颤动者作为AF组,在753例窦性心律患者中,根据年龄、性别、左室重量指数等临床资料与AF组进行1∶2配比,选择256例窦性心律者作为对照组。运用聚合酶链反应-限制性片段长度多态分析法检测p22phox基因C242T和-930A/G位点的多态性,比较两个位点的基因型及等位基因频率在两组间的分布差异。结果AF组p22phox基因C242T多态位点的TT和CT基因型以及T等位基因频率显著低于对照组(χ2=5.460,P=0.019;χ2=4.414,P=0.036)。多元logistic回归分析校正左房直径后,T等位基因携带者(TT+CT)发生房颤的风险约为CC型纯合子的0.5倍(OR=0.516,95%CI0.312～0.925,P=0.025)。p22phox基因-930A/G多态位点的基因型和等位基因频率在AF组与对照组间的分布无统计学差异。结论p22phox基因C242T位点的多态性与高血压LVH患者房颤的发生显著相关,T等位基因在其中发挥了保护性作用,而-930A/G多态与高血压LVH患者房颤的发生无关。
Objective To investigate the association between the polymorphisms of C242T and -930A / G p22phox gene and the occurrence of atrial fibrillation (AF) in hypertensive patients with left ventricular hypertrophy (LVH). Methods Eighty-eight patients with essential hypertension and LVH were enrolled in this study. One hundred and eighty-eight patients with atrial fibrillation were enrolled as the AF group. Among 753 patients with sinus rhythm, clinical data were analyzed according to age, sex and left ventricular mass index 1: 2 ratio, select 256 cases of sinus rhythm as a control group. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphisms of C242T and -930A / G loci in p22phox gene. The genotypes and allele frequencies of the two loci were compared between the two groups . Results The TT genotype and T allele frequency of C222T polymorphism site of p22phox gene in AF group were significantly lower than those in control group (χ2 = 5.460, P = 0.019; χ2 = 4.414, P = 0.036). Multivariate logistic regression analysis showed that the risk of atrial fibrillation in T allele carriers (TT + CT) was 0.5 times that of CC homozygotes (OR = 0.516, 95% CI: 0.32-0.925, P = 0.025). There was no significant difference in genotype and allele frequency between the p22phox-930A / G polymorphism loci and the control group. Conclusion The polymorphism of C242T locus in p22phox gene is significantly associated with the occurrence of atrial fibrillation in hypertensive patients with LVH, and the T allele plays a protective role in it. However, the -930A / G polymorphism and atrial fibrillation in patients with hypertensive LVH Nothing to do