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目的:探讨脑钠肽(BNP)基因多态性与慢性阻塞性肺疾病(COPD)的相关性以及在COPD基础上BNP与肺动脉高压(PH)的相关性。方法:将2014年6月至2016年1月期间,我院收治的无血缘关系的123例COPD患者,根据是否患有PH分为COPD组和COPD伴随PH组(COPD/PH组),选取65例正常人作为对照组。采用聚合酶链式反应-限制性酶切图谱分子鉴定方法鉴定BNP基因rs198 389位点基因多态性。采用酶联免疫吸附反应(ELISA)检测患者血浆中BNP蛋白、纤维蛋白原(Fbg)和小分子活性肽Apelin表达的变化。结果:BNP和Fbg在COPD组及COPD/PH组的表达较对照组明显提高,其中COPD/PH组BNP和Fbg的表达量最高,以上差异均有统计学意义(P<0.05);Apelin在COPD组及COPD/PH组的表达较对照组明显降低,其中COPD/PH组Apelin的表达量最低,以上差异均有统计学意义(P<0.05)。COPD/PH组rs198 389位点AG及GG基因型分布明显高于COPD组和对照组,COPD组高于对照组,以上差异均有统计学意义(P<0.05),且AG+GG基因型使COPD及COPD/PH患者的危险性增加。与A等位基因相比,G等位基因使患COPD和COPD伴随PH的危险性显著增加。结论:BNP基因rs198 389位点基因多态性与COPD相关,可能参与了COPD的加重并促进PH的产生。
Objective: To investigate the relationship between BNP gene polymorphism and chronic obstructive pulmonary disease (COPD) and the relationship between BNP and pulmonary hypertension (PH) based on COPD. Methods: From June 2014 to January 2016, 123 unrelated COPD patients admitted to our hospital were selected according to whether they had COPD or COPD / PH, Cases of normal people as a control group. The polymorphism of rs198 389 locus in BNP gene was identified by polymerase chain reaction-restriction fragment analysis. The changes of plasma BNP, fibrinogen (Fbg) and small molecule peptide Apelin were detected by enzyme linked immunosorbent assay (ELISA). Results: The expression of BNP and Fbg in COPD group and COPD / PH group was significantly higher than that in control group, and the expression of BNP and Fbg in COPD / PH group was the highest (P <0.05). The expression of Apelin in COPD The expression of Apelin in COPD / PH group was the lowest, the above differences were statistically significant (P <0.05). The distribution of AG and GG genotypes at rs198 389 locus in COPD / PH group was significantly higher than those in COPD group and control group, and COPD group was higher than that in control group (P <0.05). The AG + GG genotype COPD and COPD / PH patients increased risk. Compared to the A allele, the G allele increases the risk of COPD and COPD associated with PH. Conclusion: The polymorphism of rs198 389 locus in BNP gene is associated with COPD, which may be involved in the exacerbation of COPD and promote the production of PH.