基质金属蛋白酶2基因多态性与缺血性收缩性心衰预后相关

被引:3
作者
华倚虹 [1 ]
宋丽 [2 ]
吴娜琼 [1 ]
鲁向锋 [3 ]
谢高强 [4 ]
张健 [1 ]
孟宪敏 [2 ]
顾东风 [3 ]
杨跃进 [1 ]
机构
[1] 阜外心血管病医院心内科心力衰竭诊治中心
[2] 阜外心血管病医院中心实验室
[3] 阜外心血管病医院
[4] 阜外心血管病医院网络防治部
关键词
MMP-2; 多态性; 收缩性心力衰竭; 预后;
D O I
10.16563/j.cnki.1671-6272.2009.01.015
中图分类号
R541.6 [血液循环衰竭];
学科分类号
摘要
目的基质金属蛋白酶家族(Matrix metalloproteinases,MMPs)是一组蛋白溶解酶系,在心肌细胞外基质降解过程中发挥重要作用。MMP-2作为家族中的重要成员,在心力衰竭心肌重构过程中起关键作用。我们推测MMP-2基因多态性可能会影响收缩性心衰的预后。方法对387位缺血性收缩性心衰患者进行随访,用限制性片段长度多态性的方法(restriction fragment length polymor- phism,RFLP)分析MMP-2基因的三个单核苷酸多态性(single nucleotide polymorphisms,SNPs)位点rs243864,rs243866,rs17859821。结果随访到335位患者,随访率86.6%。在随访期间(0~47个月,中位随访时间24个月),有72例(21.5%)患者死亡,56例(16.7%)患者因心衰再次入院,3例(0.9%)患者再次心肌梗塞,24例(7.2%)再次血运重建。1年、2年、3年的生存率分别是86%、79%、73%。MMP-2 rs17859821 A等位基因携带者全因死亡率、心源性死亡率、心衰死亡率和主要心脏不良事件率(major adverse cardiac event,MACE)均高于GG基因型者(OR=0.513,0.416,0.472,0.671;P=0.010,0.002,0.021,0.022)。使用Cox回归分析校正年龄、束支传导阻滞、LVEF和NYHA分级后,A等位基因携带者心源性死亡率和心衰死亡率仍显著或临界显著低于GG基因型者(OR= 0.475,0.518;P=0.010,0.050)。结论研究结果提示携带MMP-2 rs17859821 A等位基因的缺血性收缩性心衰患者预后较好。
引用
收藏
页码:38 / 42
页数:5
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