胸痹心血瘀阻、痰阻心脉证与亚甲基四氢叶酸还原酶基因C677T多态性的相关性研究

发布时间：2018-03-02 19:22

本文选题：中医证型　切入点：冠心病　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：本研究通过对心血瘀阻、痰阻心脉型胸痹心痛患者行基因测序,观察MTHFR基因多态性,分析这两组证型与MTHFR基因型的相关性及其在不同基因型中的分布情况,并进一步探讨中医证型、MTHFR基因多态性对不稳定型心绞痛预后的评估作用。方法：采取前瞻性的调查研究方法,根据不稳定型心绞痛诊断标准,选择2015年3月至2015年10月期间在南京中医药大学附属医院(江苏省中医院)心血管内科住院行MTHFR基因测序的患者,符合不稳定型心绞痛西医诊断标准、中医辨证属胸痹心血瘀阻、痰阻心脉,且自愿参加本临床研究者,总的例数确定为209例。收集一般资料及出院半年后随访的不良心血管事件(MACE)等相关资料,建立数据库,应用SPSS19.0统计软件,分析胸痹心血瘀阻、痰阻心脉型与MTHFR基因型之间的相关性。结果：1.209例患者中心血瘀阻型为98例,其中基因型为CC者40例,CT者46例,TT者12例；痰阻心脉型为111例,其中基因型为CC者27例,CT者64例,TT者20例。2.胸痹心血瘀阻、痰阻心脉型与血浆同型半胱氨酸水平、MTHFR基因型均具有相关性(P0.05),MTHFR基因型与血浆同型半胱氨酸水平显著相关(P0.01)。3.两组中医证型在CC基因型中的分布有统计学差异(P0.05)；两组中医证型在CT、TT基因型中的分布均没有统计学差异(P0.05)。4.本次研究未得出两组中医证型、MTHFR基因型、血浆同型半胱氨酸水平是MACE事件的独立相关因素(P0.05)。结论：胸痹心血瘀阻、痰阻心脉证型与MTHFR基因型具有相关性。两组中医证型中,CC基因型更倾向于在心血瘀阻证中表达,CT, TT基因型在两组中医证型中的表达没有统计学差异。而两组中医证型、MTHFR基因型、血浆同型半胱氨酸水平尚不能够用于评估短期内心血管不良事件的发生率。
[Abstract]:Objective: to observe the polymorphism of MTHFR gene in patients with heart blood stasis, phlegm obstruction and heart dysmenia, and to analyze the relationship between MTHFR genotype and syndromes in these two groups and their distribution in different genotypes. To further explore the role of MTHFR gene polymorphism in evaluating the prognosis of unstable angina pectoris. Methods: according to the diagnostic criteria of unstable angina pectoris, a prospective investigation method was adopted. Patients with MTHFR gene sequencing were selected from March 2015 to October 2015 in the Department of Cardiovascular Medicine, affiliated Hospital of Nanjing University of traditional Chinese Medicine (Jiangsu Provincial Hospital of traditional Chinese Medicine). The patients met the diagnostic criteria of Western medicine for unstable angina pectoris. Traditional Chinese medicine syndrome differentiation belongs to chest obstruction of heart and blood stasis, phlegm blocking heart vein, and volunteered to participate in this clinical researcher. The total number of cases is 209 cases. Collecting general information and adverse cardiovascular events such as MACEE after half a year of discharge from hospital, and so on, the database was established. SPSS19.0 statistical software was used to analyze the relationship between heart blood stasis, phlegm obstruction and MTHFR genotype. Results 98 cases of heart blood stasis type were found in 1.209 cases, of which 40 cases were CC and 46 cases were TT. There were 111 cases of phlegm blocking heart vein type, including 27 cases with CC genotype, 64 cases with CT and 20 cases with TT. 2. There was a significant correlation between the MTHFR genotype and the plasma homocysteine level. There was a significant correlation between the MTHFR genotype and the plasma homocysteine level. There was no statistical difference in the distribution of TCM syndromes in CTGTT genotypes. 4. The two groups of TCM syndromes were not found to be MTHFR genotypes in this study. Plasma homocysteine level is an independent related factor of MACE events. There was no significant difference in the expression of TT genotype between the two groups, but there was no significant difference in the expression of TT genotype between the two groups. Plasma homocysteine levels are not yet available to assess the incidence of adverse cardiovascular events in the short term.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.22

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