Leatham E, Barley J, Redwood S, Hussein W, Carter N, Jeffery S, Bath P M, Camm A
Department of Cardiological Science, St. George's Hospital Medical School, London, UK.
J Hum Hypertens. 1994 Aug;8(8):635-8.
A deletion/insertion polymorphism in the ACE gene has been reported previously as a potent factor for myocardial infarction. We have tested the frequency of the deletion (D) allele of the ACE gene in 308 consecutive patients admitted to coronary care with chest pain. The gene frequencies were compared with those of 348 controls recruited from the London area. Of 108 Caucasian patients with myocardial infarction, the DD genotype was found more frequently than the combined DI and II genotypes (Chi-square, chi 2 = 5.07, 2P = 0.024). The overall D gene frequency was higher in myocardial infarction patients (125 of 216, 58%) than in controls (347 of 696, 49.9%) (chi 2 = 3.79, 2P = 0.052). In contrast, the DD genotype and D allele frequencies in patients with unstable angina were similar to those found in our normal population. A nonsignificant difference in allele frequency between myocardial infarction and unstable angina patients was observed but the small numbers of subjects studied precludes a more formal comparison. Since unstable angina and myocardial infarction represent a spectrum of coronary thrombosis, it is possible that the DD genotype favours the development of myocardial infarction, perhaps through the presence of higher serum ACE concentrations.
先前已有报道称，ACE基因中的缺失/插入多态性是心肌梗死的一个重要因素。我们检测了308例因胸痛入住冠心病监护病房的连续患者中ACE基因缺失（D）等位基因的频率，并将基因频率与从伦敦地区招募的348名对照者进行了比较。在108例白种人心肌梗死患者中，发现DD基因型的频率高于DI和II基因型之和（卡方检验，χ2 = 5.07，P = 0.024）。心肌梗死患者的总体D基因频率（216例中的125例，58%）高于对照组（696例中的347例，49.9%）（χ2 = 3.79，P = 0.052）。相比之下，不稳定型心绞痛患者的DD基因型和D等位基因频率与正常人群相似。心肌梗死患者和不稳定型心绞痛患者之间的等位基因频率存在非显著性差异，但由于研究的样本量较小，无法进行更正式的比较。由于不稳定型心绞痛和心肌梗死代表了冠状动脉血栓形成的一个连续谱，因此DD基因型可能通过较高的血清ACE浓度促进心肌梗死的发生。
