摘要
目的 探讨乙醛脱氢酶2(ALDH2)单核苷酸多态性与冠心病(CHD)稳定型心绞痛患者硝酸甘油(GTN)疗效的关系.方法 选取2022年4月-2023年4月崇州市人民医院收治的168例CHD稳定型心绞痛患者;患者心绞痛急性发作后,自行舌下含服GTN治疗.根据患者服用GTN后是否有效分为有效组(n=122)和无效组(n=46);二组均采集空腹静脉血2ml,检测ALDH2(rs671)单核苷酸多态性;收集二组一般资料、血生化及影像学检查结果,采用单因素分析及多因素Logsitic回归分析GTN疗效的的影响因素.结果 168例CHD稳定型心绞痛患者中GG基因型占58.33％(98/168),GA基因型占32.14％(54/168),AA基因型占9.52％(16/168);GTN治疗有效组和无效组患者的ALDH2基因型分布和等位基因频率比较,差异均有统计学意义(P＜0.05);单因素分析结果表明年龄、性别、体质量指数(BMI)、糖尿病、高血压、血脂异常、家族史、Gensini评分、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、空腹血糖(FPG)以及左室射血分数(LVEF)比较差异均无统计学意义(P＞0.05);多因素Logistic回归分析提示ALDH2(rs671)AA基因型及ALDH2(rs671)A等位基因是服用GTN无效的独立危险因素(P＜0.05).结论 ALDH2单核苷酸多态性(rs671)AA基因型是CHD稳定型心绞痛患者含服GTN治疗无效的独立危险因素.
Abstract
Objective To explore the relationship between single nucleotide polymorphisms of aldehyde dehy-drogenase-2(ALDH2)and the efficacy of glyceryl trinitrate(GTN)in patients with stable angina pectoris of coronary heart disease(CHD).Methods One hundred and sixty-eight patients with stable angina pectoris of CHD admitted to Chongzhou People's Hospital were enrolled between April 2022 and April 2023.After acute attack of angina pectoris,they were treated with sublingual GTN.According to GTN efficacy,patients were di-vided into effective group(n=122)and ineffective group(n=46).The fasting venous blood(2ml)was col-lected in both groups to detect single nucleotide polymorphisms of ALDH2(rs671).The general data,blood biochemistry and imaging examinations results in the two groups were collected.The influencing factors of GTN efficacy were analyzed by univariate analysis and multivariate Logsitic regression analysis.Results In 168 patients with stable angina pectoris of CHD,proportions of GG genotype,GA genotype and AA genotype were 58.33％(98/168),32.14％(54/168)and 9.52％(16/168),respectively.There were significant differ-ences in distribution of ALDH2 genotypes and frequencies of alleles between effective group and ineffective group(P＜0.05).The results of univariate analysis showed that there was no significant difference in age,gen-der,body mass index(BM1),diabetes mellitus,hypertension,dyslipidemia,family history,Gensini scores,tri-glyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FPG)or left ventricular ejection fraction(LVEF,P＞0.05).Mult-ivariate Logistic regression analysis showed that AA genotype and A allele in ALDH2(rs671)were independ-ent risk factors of GTN ineffectiveness(P＜0.05).Conclusion The single nucleotide polymorphisms of AL-DH2(rs671)are closely related to GTN efficacy in patients with stable angina pectoris of CHD.A A genotype and A allele in ALDH2(rs671)are independent risk factors of GTN ineffectiveness.
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