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目的 为了探讨2型糖尿病(diabetes mellitus,DM)患者血管紧张素转换酶(angiotensinconverting enzyme,ACE)基因与运动诱发的隐性心肌缺血(exercise- induced silent myocardial ischemia,SI)的关系。方法 选择静息心电图正常的2型DM患者10 8例和5 0名健康人。采用踏车运动试验进行筛选SI。应用PCR技术检测ACE基因。结果 (1)对照组及2型DM组ACE基因型及等位基因频率分布相似(P>0 .0 5 )。与非SI组比较,SI组ACE D等位基因频率明显增高(χ2 =4 .5 0 1,P<0 .0 5 ) ,两组ACE基因型频率分布相似(P>0 .0 5 )。(2 ) 2型DM患者不同ACE基因型组间临床特征及血脂水平相似(P>0 .0 5 )。(3) 2型DM患者DD型SI发生率为6 8.2 % ,明显高于II基因型组的39.5 % (χ2 =4 .5 93,P<0 .0 5 )。结论 ACE D等位基因增高2型DM患者并发SI的危险性。
Objective To investigate the relationship between angiotensin converting enzyme (ACE) gene and exercise-induced silent myocardial ischemia (SI) in patients with type 2 diabetes mellitus (DM). Methods One hundred and eight patients with type 2 DM with normal resting electrocardiogram and 50 healthy people were selected. Treadmill exercise test to screen SI. ACE gene was detected by PCR. Results (1) The frequencies of ACE genotypes and alleles in control group and DM group were similar (P> 0.05). Compared with non-SI group, the frequency of ACE D allele in SI group was significantly higher than that in non-SI group (χ2 = 4.501, P <0.05). There was a similar frequency distribution of ACE genotype in both groups (P> 0.05). (2) The clinical features and blood lipid levels of different ACE genotypes in type 2 DM patients were similar (P> 0.05). (3) The incidence of DD type SI in DM type 2 patients was 62.2%, significantly higher than that in II genotype group (χ2 = 4.593, P <0.05). Conclusion The ACE D allele increases the risk of SI in type 2 DM patients.