许贻白 王贤军 诸金水 王亚仙 戴利成 313000 浙江湖州市第二医院 中华神经科杂志 1998 0 31 3


    关键词：脑血管意外；；基因；ACE；血管紧张素II 期刊 zhsjkzz 0 *论著* fur -->


    

【 摘要】 目的 研究血管紧张素转换酶(ACE)基因多态性和急性脑血管病(ACVD)的发病关系。方法 应用PCR方法检测150例ACVD患者和117名正常人ACE基因的缺失/插入多态性，同时测定血浆血管紧张素II(AngII)水平。结果 ACVD患者的ACE基因型及等位基因频率和正常对照组比较差异无显著意义，脑卒中和高血压家族史阳性患者的DD型及D等位基因频率明显高于阴性家族史的患者。ACVD患者血浆AngII水平显著高于正常对照，DD型患者的血浆Ang II水平明显高于II型患者，AngII水平随出血量及梗死范围增大而升高，死亡患者Ang II水平显著高于存活组。结论

    有脑卒中和高血压家族史的DD型ACE基因携带者具有卒中易感性，在这些人群中进行ACE基因调查有助于脑血管病的防治。血浆AngII水平还可作为判断病情预后的一项临床指标。

    Angiotensin converting enzyme gene polymorphism andcerebrovascular disease Xu Yibai, Wang Xianjun, Zhu Jinshui, et al. Huzhou Second Hospital, Huzhou 313000

    【Abstract】 Objective The purpose of thestudy was to investigate the relationship between the polymorphism of the angiotensinconverting enzyme(ACE) gene and the coming on of acute cerebrovascular disease. Method An insertion/deletion polymorphism of the ACE gene was analysed bypolymerase chain reaction and plasma angiotensinII levels were determined in 150 cases ofstroke and 117 control subjects. Results Nodifference in genotype and allele gene frequency was observed between the patients withstroke and the control subjects and also between the control subjects and the patientswith cerebral hemorrhage or with cerebral infarction. The frequency of the DD genotype ofthe ACE gene was significantly higher in the patients with the family history of stroke orhypertension (0.24 and 0.44) than in the patients without the family history of stroke orhypertension(0.20 and 0.17)(χ² =9.61 and14.58, P<0.01).The frequency of the D allele was also significantly higher in thepatients with than in those without the family history of stroke or hypertension(0.51 and0.66 vs 0.35 and 0.34, χ² =6.20, P<0.05and χ² =18.53, P<0.01).The levels of theplasma angiotensin II were significantly higher in the patiens with stroke than in thecontrol subjects (104±31 ng/L vs 90±12ng/L, P<0.01). Besides, the DD genotype of theACE gene was associated with the higher concentrations of plasma angiotensin II.Conclusion These suggested that the DD genotypeincreased riske of stroke in the subjects who had the family history of stroke orhypertension and investigation of ACE genotype among these persons might be of help forprevention of stroke.The level of plasma angiotensin II was related to the prognosis ofstroke.

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