梁荣珍　王太成

[摘要] 目的 探讨生长分化因子-15（GDF-15）基因rs1058587多态性与急性心肌梗死（AMI）的关系。 方法 选取2016年3月～2017年1月海南医学院第二附属医院心血管内科确诊AMI患者120例为AMI组，同期选取健康对象120例为健康组。采用聚合酶链反应PCR技术检测两组的GDF-15基因rs1058587位点基因型、等位基因频率，并探讨其与患者并发AMI的关系。 结果 AMI组的GDF-15基因rs1058587位点的CC、CG、GG基因型与健康组比较，差异有统计学意义（P < 0.05）；AMI组的GDF-15基因rs1058587位点等位基因G频率显著高于健康组（P < 0.05）；采用多因素Logistic回归分析结果显示：高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高、血清脂蛋白（a）升高、尿微量白蛋升高、GDF-15基因rs1058587位点的等位基因G是并发AMI的独立危险因素（P < 0.05）。 结论 GDF-15基因rs1058587多态性与人群发生AMI具有密切的关系。

[关键词] 生长分化因子-15基因；rs1058587位点；急性心肌梗死

[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-7210（2018）04（b）-0067-04

[Abstract] Objective To investigate the relationship between rs1058587 polymorphism of GDF-15 gene and acute myocardial infarction （AMI）. Methods From January 2016 to January 2017， 120 patients with AMI of Cardiovascular Medicine Department in the Second Affiliated Hospital of Hainan Medical University were selected as AMI group. In the same period， 120 healthy subjects were selected as health group. The two groups were used by polymerase chain reaction PCR GDF-15 gene rs1058587 locus genotypes， allele frequencies， and explore its relationship with patients with concurrent AMI. Results The genotypes of CC， CG and GG at rs1058587 of GDF-15 gene in AMI group were compared with health group， the difference was statistically significant （P < 0.05）. The frequency of G allele of rs1058587 in GDF-15 gene in AMI group was higher than health group （P < 0.05）. The results of Logistic multifactor regression analysis showed that the decrease of high-density lipoprotein cholesterol and the rise of Low density lipoprotein cholesterol， serum lipoprotein （a）， minim white egg， the allele G at rs1058587 in GDF-15 gene were the independent risk factor for concurrent AMI （P < 0.05）. Conclusion Rs1058587 polymorphism of GDF-15 gene is closely related to AMI occurrence in population.

[Key words] Growth-differentiation factor-15 gene； Rs1058587 locus； Acute myocardial infarction

近年來我国冠心病等心血管疾病发病率常处于高位，冠心病患者常伴发急性心肌梗死（acute myocardial infarction，AMI），AMI是冠心病的一种急性事件，患者常出现冠脉血流闭塞。有研究发现AMI患者侧支血管形成对心梗患者（特别是发病4～12 h的AMI患者）的梗死面积大小具有明显的调节作用，此外侧枝循环的完善对于保持AMI相关区域心肌的活性，保护心肌功能，改善患者的临床预后具有重要作用[1]。故而，探寻AMI时侧枝循环的形成相关因子研究已成为目前临床和生物学研究的重要方向。

最新的资料显示，AMI患者血清生长分化因子-15（growth differentiation factor-15，GDF-15）可出现明显升高[2]。GDF-15是重要的心血管系统保护因子可参与侧枝血管循环的建立过程，其形成主要受GDF-15基因的调节作用，GDF-15基因在应激条件下被诱导表达并在人体内执行广泛的保护功能，而人群GDF-15的生物学活性和表达水平存在差异，并与疾病的发生、严重程度和预后具有明显相关性[3]。本研究深入探讨了GDF-15基因rs1058587多态性与AMI的关系，旨在为AMI患者的预防和预后提供新的思路。……