CAJ | 학술논문

目的：研究脂蛋白（a）[Lp（a）]及其基因多态性与退化性钙化性主动脉瓣膜病（DCAVD ）的相关性。方法：入选2010年2月至2014年1月在我院收治的DCAVD患者164例（DCAVD组），并选择同期在本院健康体检者164例为对照（正常对照组）。比较分析Lp（a）水平及其基因多态性与主动脉瓣膜钙化的关系，利用Logistic回归分析分析DCAVD的独立危险因素。结果：人群中的Lp（a）基因存在rs10455872、rs6415084、rs3798221和rs7770628位点变异。在DCAVD组中，rs10455872基因表型的AG基因型的Lp （a ）水平显著高于AA基因型[（325.5±108.2）mg／L比（211.7±135.4） mg／L]，rs6415084基因表型的CC＋ TT基因型的 Lp（a）水平显著高于CT基因型[（287.9±144.1）mg／L比（240.7±127.2）mg／L]，rs7770628基因表型的TT＋CC基因型的Lp（a）水平显著高于CT基因型[（304.1±124.1）mg／L比（226.8±101.6）mg／L ]，P＜0.05或＜0.01；rs10455872的 AG基因型的瓣膜钙化患者比例显著高于AA基因型（90.0％比61.7％），rs6415084的CC＋TT基因型的瓣膜钙化患者比例显著高于 CT基因型（83.8％比66.7％），rs7770628的TT＋CC基因型的瓣膜钙化患者比例显著高于 CT基因型（87.3％比63.4％），P＜0.05或＜0.01。Logistic回归分析显示rs10455872，rs6415084，rs7770628和Lp（a）水平是DCAVD的瓣膜钙化病变的独立危险因素（OR＝1.67～2.31， P均＜0.01）。结论：Lp（a）基因多态性（rs10455872、rs6415084、rs7770628）和血浆脂蛋白（a）水平与DCAVD 的瓣膜钙化显著相关，可能是DCAVD发生的易感基因。
목적：연구지단백（a）[Lp（a）]급기기인다태성여퇴화성개화성주동맥판막병（DCAVD ）적상관성。방법：입선2010년2월지2014년1월재아원수치적DCAVD환자164례（DCAVD조），병선택동기재본원건강체검자164례위대조（정상대조조）。비교분석Lp（a）수평급기기인다태성여주동맥판막개화적관계，이용Logistic회귀분석분석DCAVD적독립위험인소。결과：인군중적Lp（a）기인존재rs10455872、rs6415084、rs3798221화rs7770628위점변이。재DCAVD조중，rs10455872기인표형적AG기인형적Lp （a ）수평현저고우AA기인형[（325.5±108.2）mg／L비（211.7±135.4） mg／L]，rs6415084기인표형적CC＋ TT기인형적 Lp（a）수평현저고우CT기인형[（287.9±144.1）mg／L비（240.7±127.2）mg／L]，rs7770628기인표형적TT＋CC기인형적Lp（a）수평현저고우CT기인형[（304.1±124.1）mg／L비（226.8±101.6）mg／L ]，P＜0.05혹＜0.01；rs10455872적 AG기인형적판막개화환자비례현저고우AA기인형（90.0％비61.7％），rs6415084적CC＋TT기인형적판막개화환자비례현저고우 CT기인형（83.8％비66.7％），rs7770628적TT＋CC기인형적판막개화환자비례현저고우 CT기인형（87.3％비63.4％），P＜0.05혹＜0.01。Logistic회귀분석현시rs10455872，rs6415084，rs7770628화Lp（a）수평시DCAVD적판막개화병변적독립위험인소（OR＝1.67～2.31， P균＜0.01）。결론：Lp（a）기인다태성（rs10455872、rs6415084、rs7770628）화혈장지단백（a）수평여DCAVD 적판막개화현저상관，가능시DCAVD발생적역감기인。
Objective:To study the correlation among lipoprotein (a) [Lp (a)] ,its gene polymorphism and degenera‐tive calcific aortic valve disease (DCAVD) .Methods :From Feb 2010 to Jan 2014 ,a total of 164 DCAVD cases trea‐ted in our hospital were enrolled as DCAVD group ,another 164 healthy subjects undergoing physical examination in the same period were selected as normal control group .Relationship among Lp (a) level ,its gene polymorphism and aortic valvular calcification was compared and analyzed ,and Logistic regression analysis was used to analyze in‐dependent risk factors of DCAVD . Results :Lp (a ) gene possesses four point mutations in population , namely rs10455872 ,rs6415084 ,rs3798221 and rs7770628. In DCAVD group ,Lp (a) level of AG genotype was significantly higher than that of AA genotype [ (325.5 ± 108.2) mg/L vs .(211.7 ± 135.4) mg/L] in rs10455872 gene pheno‐type ,Lp (a) level of CC+TT genotype was significantly higher than that of CT genotype [ (287.9 ± 144.1) mg/L vs .(240.7 ± 127.2) mg/L] in rs6415084 gene phenotype ,and Lp (a) level of TT+ CC genotype was significantly higher than that of CT genotype [(304.1 ± 124.1) mg/L vs .(226.8 ± 101.6) mg/L] in rs7770628 gene phenotype , P<0.05 or <0.01 ;patient′s percentage of valvular calcification of AG genotype was significantly higher than that of AA genotype (90.0% vs .61.7% ) in rs10455872 , patients percentage of valvular calcification of CC +TT geno‐type was significantly higher than that of CT genotype (83.8% vs .66.7% ) in rs6415084 ,and patient′s percentage of valvular calcification of TT+CC genotype was significantly higher than that of CT genotype (87.3% vs .63.4% ) in rs7770628 , P<0.05 or <0.01. Logistic regression analysis indicated that rs10455872 ,rs6415084 ,rs7770628 and Lp (a) level were independent risk factors for valvular calcification of DCAVD (OR=1.67~2.31 , P<0.01 all) . Conclusion :Lp (a) gene polymorphism (rs10455872 ,rs6415084 and rs7770628) and plasma Lp (a) level are signifi‐cantly correlated to valvular calcification of DCAVD ,which may be susceptible genes for DCAVD occurrence .