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目的研究中国人群中纤维蛋白原βG-455A基因多态性与血浆纤维蛋白原水平及冠心病亚型的关系。方法1 485例因胸痛或非侵入性检查提示心肌缺血的成年人进行了冠状动脉造影检查,根据临床表现及冠状动脉造影结果被分为冠心病组(n=1 019)及对照组(n=466),冠心病组又被分为稳定型心绞痛(SAP)组(n=674)及急性冠状动脉综合征(ACS)组(n=345)。应用vonClauss法测定血浆纤维蛋白原水平,多聚酶链反应(PCR)和HaeⅢ内切酶技术检测纤维蛋白原βG-455A基因多态性。结果ACS组及SAP组的血浆纤维蛋白原水平较对照组显著升高,其中ACS组最高(ACS组380.92±92.35 mg/dL,SAP组352.49±94.89 mg/dL,对照组311.72±87.09 mg/dL,三组之间两两比较,P均<0.001)。在对照组及SAP组中基因型为AA的纯合子其血浆纤维蛋白原水平较携带G等位基因的个体为高(对照组AA为363.83±76.66 mg/dL,与GA的337.83±77.43mg/dL或GG的295.28±88.06 mg/dL比较,P均<0.05;SAP组AA为429.82±93.35 mg/dL,与GA的368.30±90.39 mg/dL或GG的337.89±94.32 mg/dL比较,P均<0.05),而在ACS组未见此趋势。各组之间的基因型及等位基因频率分布差异无统计学意义(P>0.05),-455A等位基因与冠心病发病风险无相关性。结论血浆纤维蛋白原水平升高与冠心病发病风险相关。纤维蛋白原βG-455A基因多态性与冠心病发病无相关性。
Objective To study the relationship between fibrinogen βG-455A polymorphism and plasma fibrinogen level and coronary heart disease subtype in Chinese population. Methods A total of 1 485 adults with myocardial ischemia induced by chest pain or noninvasive examination underwent coronary angiography and were divided into coronary heart disease group (n = 1019) and control group (n = 1019) according to clinical manifestations and coronary angiography results = 466). The CHD group was further divided into stable angina pectoris group (n = 674) and acute coronary syndrome group (n = 345). The plasma fibrinogen level was detected by vonClauss method, and the polymorphism of fibrinogen βG-455A gene was detected by polymerase chain reaction (PCR) and Hae III endonuclease technique. Results The levels of plasma fibrinogen in ACS group and SAP group were significantly higher than those in control group (ACS group, 380.92 ± 92.35 mg / dL, 352.49 ± 94.89 mg / dL in SAP group and 311.72 ± 87.09 mg / dL in control group , Any pairwise comparisons among the three groups, P <0.001). In the control group and the SAP group, homozygote with genotype AA had higher plasma fibrinogen level than those with G allele (AA of 363.83 ± 76.66 mg / dL in control group and 337.83 ± 77.43 mg / (P <0.05). The AA of the SAP group was 429.82 ± 93.35 mg / dL, which was significantly higher than that of GA (368.30 ± 90.39 mg / dL) or GG (337.89 ± 94.32 mg / dL) <0.05), but no such trend in ACS group. There was no significant difference in genotype distribution and allele frequencies between groups (P> 0.05). There was no correlation between - 455A allele and risk of coronary heart disease. Conclusion The elevated plasma fibrinogen level is associated with the risk of coronary heart disease. There was no correlation between fibrinogen βG-455A polymorphism and coronary heart disease.