关键词：心肌梗塞；血小板膜糖蛋白类；基因
【摘要】 目的 评价我国人群心肌梗塞的发生与血小板膜糖蛋白(glycoprotein,GP) Ib基因多态性的关系。方法 采用病例对照研究，选择100例确诊心肌梗塞的患者(急性或陈旧性)和104例无心脏病史者作对照，用PCR-SSP的方法进行血小板GPIbα链的基因多态性检测。结果 对照组无Met/Met纯合子，Thr/Met占16.3%；心肌梗塞组Thr/Met+Met/Met共占30%，与对照组相比，P=0.02，比数比(oddsratio,OR) 为2.2(95%可信区间1.1～4.3)。在≤60岁发生心肌梗塞的患者Thr/Met+Met/Met之和的频率(42.2%)更明显高于≤60岁的对照组(14.5%)(P=0.002，OR=4.3，95%可信区间1.7～10.8)。结论 血小板GPIb中Met等位基因与心肌梗塞之间呈显著的相关性，在≤60岁的人中，此种相关性更强。
Correlation between thepolymorphism of platelet glycoprotein I b gene and myocardial infarction
ZHANG Tong, XU Chengbin, WANG Shenwu. Department of Cardiology, People′s Hospital, Beijing MedicalUniversity, Beijing 100044
【 Abstract】 Objective Platelet glycoprotein (GP) Ib/IX complex is the receptorof von Willebrand factor (vWF), which mediates shear stress-dependent platelet activation.It may be involved in the pathogenesis of acute coronary syndrome. The correlation betweenmyocardial infarction (MI) and platelet GPIb polymorphism was assessed.Methods Genotypes of the α -chain of the receptor (GP Ibα , 145 Thr/Met)were determined in 100patients with MI as well as in 104 individuals from the general population with no historyof any heart disease with PCR-SSP (sequence specific primers). Results The prevalence of theMet/Met(M/M) and Thr/Met (T/M) genotype in MI patients was significantly different fromthat in the control group (30% vs 16.3%, P=0.02, odds ratio=2.2, 95%CI 1.1-4.3). And thefrequency of M/M and T/M was significantly higher in patients aged ≤60 years (42.2%) than in the control subjects aged ≤ 60 years (14.5%) (P=0.002, odds ratio=4.3, 95%CI 1.7-10.8). Conclusion The study suggests that there is a strong correlationbetween the presence of the Met allele in GP Ibα and myocardial infarction, and this correlation isstronger in patients who had had myocardial infarction before the age of 60 years. Theresults need to be confirmed in a large scale study.
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