乙醛脱氢酶2基因型多态性与早发冠心病患者冠状动脉狭窄程度的关系

杨美艳; 韩博; 徐勇; 杨朝荣; 盛名; 郭爽; 王蕾

doi:10.3969/j.issn.2095-5227.2021.01.002

乙醛脱氢酶2基因型多态性与早发冠心病患者冠状动脉狭窄程度的关系

Relationship between ALDH2 polymorphisms and coronary stenosis severity in patients with premature coronary artery disease

摘要

摘要:
背景乙醛脱氢酶2(aldehyde dehydrogenase 2，ALDH2)是线粒体内代谢乙醛的重要酶，越来越多的研究表明其对心血管疾病(高血压、心功能不全、缺血再灌注损伤等)患者有保护作用，然而ALDH2基因型多态性与早发冠心病关系的研究甚少。
目的探讨ALDH2基因型多态性与早发冠心病患者冠状动脉狭窄程度的关系。
方法选取2018年1 - 12月北京昌平区医院心内科拟诊为早发冠心病患者204例作为受试者，年龄18～65岁。应用ALDH2基因试剂盒行基因型检测，根据检测结果分为两组：基因为野生型(ALDH2 *1/*1)组，基因突变杂合子型(ALDH2 *1/*2)与纯合子型(ALDH2 *2/*2)组。由同一介入治疗团队行冠状动脉造影术，根据造影结果计算冠状动脉病变Gensini积分，并比较支架置入情况。
结果 ALDH2野生型130例，突变杂合子型61例，突变纯合子型13例。野生型组与非野生型组年龄、性别、体质量指数、血脂指标、高血压病史、冠心病家族史、吸烟史、饮酒史差异均无统计学意义，但野生型组中位Gensini积分更低22(10, 49) vs 26(8, 44)，P=0.01，中位置入支架数量更少1(0, 2) vs 2(0, 3)，P=0.01。
结论 ALDH2基因型多态性与早发冠心病患者冠状动脉狭窄程度密切相关，ALDH2基因突变型患者冠状动脉狭窄程度更重。

Abstract:
Background Increasing evidences indicate that aldehyde dehydrogenase 2 (ALDH2) is a key enzyme of cytoprotection for the cardiovascular diseases, such as hypertension, heart failure, ischemia reperfusion injury, and so on. However, few studies have been conducted on the relationship between ALDH2 genotype polymorphism and premature coronary artery disease.
Objective To investigate the relationship between ALDH2 genotype polymorphism and coronary stenosis severity in patients with premature coronary artery disease.
Methods Totally 204 hospitalized patients (16-65 years) with premature coronary artery disease were assessed in Changping Hospital, and they were divided into wild genotype group (GG) and mutant genotypes group (GA or AA) according to their ALDH2 genotypes. The baseline data and Gensini score were measured. Results There were 130 cases in the ALDH2 wild genotype group, 61 cases in the mutant heterozygous genotype and 13 cases in the mutant homozygous genotype. The Gensini score (MdIQR:2210, 49 vs 268, 44, P =0.01) and the number of stents (Md IQR:10, 2 vs 20, 3, P=0.01) in the wild genotype group were lower than that in the mutant genotype group with statistically significant differences. Conclusion ALDH2 genotypes are closely related to coronary stenosis severity in patients with premature coronary artery disease, and coronary stenosis is more severe in patients with ALDH2 gene mutation.

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