睡眠中间歇低氧伴高血压患者与不同血管紧张素转换酶基因型关系的研究

摘要

Objective To investigate the association between the angiotensin converting enzyme (ACE) gene polymorphism and intermittent hypoxia during sleep- obstructive sleep apnea-hypopnea syndrome (OSAHS)-with high blood pressure. Methods The types of ACE gene were examined by polymerase chain reaction (PCR) in 51 OSAHS with high blood pressure patients and 60 healty people. The effect of ACE polymorphism in the OSAHS with high blood pressure group on parameters of polysomnography,sex, systolic pressure and diastolic pressure were analyzed. Results Compared with those of the control group, the distributions with DD genotype were significantly higher than those with Ⅱ/ID genotype , the frequencies with D allele were significantly higher than those with I allele; systolic pressure, diastolic pressure and apnea hypopnea index (AHI) were significantly higher, and the average saturation (SaO2)at night was significantly lower in the patients. The DD genotype frequencies of OSAHS with high blood pressure were higher than Ⅱ/ID genotype. Compare with those of the Ⅱ/ID genotype in the OSAHS with high blood pressure group, AHI and systolic pressure were significantly higher, the average SaOzwas significantly lower, and male patients were more common in patients with the DD genotype. Conclusion The DD genotype of ACE gene may be related to OSAHS with high blood pressure, and the D allele may be an important candidate gene. OSAHS is the independent factor of high blood pressure, the blood pressure increases with OSAHS severity, and male patients are common.%目的 探讨睡眠中间歇低氧-阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴高血压患者与血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性的关系.方法 采用聚合酶链反应技术对2009年1月至2009年12月沈阳医学院奉天医院经多导睡眠监测(PSG)诊断为OSAHS且伴高血压的51例患者(试验组)及60例健康人进行ACE基因型检测,分析ACE基因型(ID组、II组及DD组)与OSAHS伴高血压患者之间关系.结果 与对照组相比,试验组DD基因型显著高于II和ID基因型,等位基因频率D显著高于I(P＜0.01),收缩压、舒张压、呼吸暂停低通气指数(AHI)水平显著高于对照组(P＜0.01),夜间平均血氧饱和度(平均SaO2)显著低于对照组(P＜0.01).试验组中DD基因型频率显著升高(P＜0.01),与ID、II基因型对比,收缩压及AHI均显著升高(P＜0.05,P＜0.01),平均SaO2显著低于对照组(P＜0.05),男患多见(P＜0.01).随AHI增加,D等位基因表达增高,收缩压显著升高,平均SaO2显著降低.结论 OSAHS伴高血压患者与ACE基因DD基因型相关,D等位基因可能为易感基因.OSAHS是高血压的独立危险因素,OSAHS越重,血压越高,且男性多发.