梁灼源 韦锋 欧阳楚君 冯明亮 郭静静 卢瑞荣

[摘要]目的探討血管紧张素原（AGT）基因 M235T 位点多态性与高尿酸血症（HUA）易感性的关系。方法以2018年5月至2020年4月江门市中心医院风湿免疫科312例 HUA 患者为高尿酸血症组，并以同期286例原发性痛风患者为痛风组，357例正常人群为正常组。比较三组的 AGT 基因 M235T 位点多态性，分析 AGT 基因 M235T 位点多态性与 HUA、痛风发生的关系;根据 HUA 治疗效果将高尿酸血症组分为有效组及无效组，比较两组的AGT基因 M235T位点多态性，分析AGT基因 M235T位点多态性与 HUA 治疗效果的关系。结果高尿酸血症组、痛风组和正常组的 MM、MT、TT 实际频数与理论频数比较，差异均无统计学意义（P >0.05）;高尿酸血症组、痛风组的 AGT 基因 M235T 位点 MT、TT 检出率高于正常组（ P <0.05）;二元 logistic 回归分析显示，AGT 基因 M235T 位点 MT、TT 型是 HUA 及痛风发生的危险因素， MM 型为保护因素（ P <0.05）。有效组的 AGT 基因 M235T 位点 MM 型检出率高于无效组（ P <0.05）;二元 logistic 回归分析显示， AGT 基因 M235T 位点多态性不是影响 HUA 治疗效果的相关因素（ P >0.05）。结论 AGT 基因 M235T 位点多态性是影响 HUA 及痛风发生的危险因素，但与 HUA 治疗效果无关。

[关键词]血管紧张素原基因;基因多态性;高尿酸血症;痛风;易感性

[中图分类号] R692.9;R589.7  [文献标识码] A   [文章编号]2095-0616（2021）23-0195-04

Analysis  of the relationship between angiotensinogen gene polymorphism and susceptibility of hyperuricemiaLIANG  Zhuoyuan    WEI  Feng    OUYANG  Chujun    FENG  Mingliang    GUO  JingjingLU  Ruirong

Department of Rheumatology and Immunology， Jiangmen Central Hospital， Guangdong， Jiangmen 529000， China

[Abstract] Objective To explore the relationship between the M235T polymorphism of the angiotensinogen （AGT） gene and the susceptibility of hyperuricemia （HUA）. Methods A total of 312 HUA patients admitted to the Department of Rheumatology and Immunology of Jiangmen Central Hospital from May 2018 to April 2020 were selected as the hyperuricemia group， and 286 patients with primary gout in the same period were selected as the gout group， and 357 normal people were regarded as the normal group. The M235T polymorphism of the AGT gene was compared among the three groups， and the relationship between the M235T polymorphism of the AGT gene and the occurrence of HUA and gout was analyzed. According to the HUA treatment effect， the hyperuricemia group was divided into the effective group and the ineffective group， the M235T polymorphism of the AGT gene was compared between the two groups， and the relationship between the M235T polymorphism of the AGT gene and HUA treatment effect was analyzed. Results There were no statistically significant differences between the actual frequency and theoretical frequency of MM， MT and TT genotypes among the hyperuricemia group， the gout group and the normal group （P >0.05）. The detection rates of MT and TT genotypes of AGT M235T in the hyperuricemia group and gout group were higher than those in the normal group （P <0.05）. Binary logistic regression analysis showed that MT and TT genotypes of AGT M235T were risk factors for the occurrence of HUA and gout， and MM genotype was a protective factor （P <0.05）. The detection rate of the MM genotype of AGT M235T in the effective group was higher than that in the ineffective group （P <0.05）. Binary logistic regression analysis showed that the M235T polymorphism of the AGT gene was not a related factor affecting HUA treatment effect （P >0.05）. Conclusion The M235T polymorphism of the AGT gene is a risk factor affecting the occurrence of HUA and gout， but it did not affect the effect of HUA treatment.

[Key words] Angiotensinogen gene; Gene polymorphism; Hyperuricemia; Gout; Susceptibility

高尿酸血症（HUA）是嘌呤代谢紊乱所致疾病，多因肾脏及肠道排泄障碍或尿酸生成过多所致，患者会出现痛风性急性关节炎、痛风石沉积等症状，严重影响其日常生活[1]。既往研究指出， HUA 发生除了与患者日常饮食、高血压、机体代谢紊乱等有关外，还与遗传易感性相关[2]。血管紧张素原（AGT）基因可通过调控血管紧张素Ⅰ、Ⅱ合成，以影响肾素-血管紧张素系统的激活，进而导致肾脏功能异常[3]。笔者认为，AGT 基因多态性或可通过影响肾脏功能来抑制血尿酸的排泄，但目前有关其与 HUA 易感性的研究尚处于探索阶段。故本……