作者：张瑶，张毅，陈芸，郭洪波，郭晓玲，车晓芳

单位：

1.030000山西省太原市，山西医科大学第一临床医学院　2.030000山西省太原市，山西医科大学第一医院老年病科　3.030000山西省太原市，山西医科大学第一医院中医科

Units：

1.The First Clinical College of Medicine, Shanxi Medical University, Taiyuan 030000, China2.Department of Gerontology, the First Hospital of Shanxi Medical University, Taiyuan 030000, China3.Department of Traditional Chinese Medicine, the First Hospital of Shanxi Medical University, Taiyuan 030000, China

关键词：

高血压；认知障碍；老年人；亚甲基四氢叶酸还原酶；血管紧张素转换酶；基因型

Keywords：

Hypertension; Cognition disorders; Aged; Methylenetetrahydrahydrofolate reductase; Angiotensinconverting enzyme; Genotype

CLC：

R 544.1

DOI：

10.12114/j.issn.1008-5971.2023.00.190

Funds：

山西省卫生健康委科研项目（2022040）

摘要：

目的　探讨亚甲基四氢叶酸还原酶（MTHFR）基因C677T位点和血管紧张素转换酶（ACE）基因插入/缺失（I/D）基因型与老年高血压患者合并轻度认知障碍（MCI）的关系。方法　选取2022年6月至2023年4月山西医科大学第一医院老年病科收治的老年高血压患者80例为研究对象，收集患者的临床资料，采用飞行时间质谱法检测MTHFR基因C677T位点、ACE基因I/D基因型。根据是否合并MCI将患者分为病例组和对照组。采用多因素Logistic回归分析探讨老年高血压患者合并MCI的影响因素。结果　病例组43例，对照组37例。病例组同型半胱氨酸（Hcy）水平高于对照组（P＜0.05）。两组MTHFR基因C677T位点、ACE基因I/D基因型比较，差异有统计学意义（P＜0.05）。多因素Logistic回归分析结果显示，Hcy、MTHFR基因C677T位点TT基因型是老年高血压患者合并MCI的影响因素（P＜0.05）。结论　Hcy升高、MTHFR基因C677T位点TT基因型是老年高血压患者合并MCI的危险因素，尚未发现ACE基因I/D基因型与老年高血压患者合并MCI相关。

Abstract：

Objective To investigate the relationship between methylenetetrahydrofolate reductase (MTHFR) geneC677T locus and angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) genotype and mild cognitive impairment (MCI)in elderly patients with hypertension. Methods A total of 80 elderly hypertensive patients who admitted to the Department ofGerontology of the First Hospital of Shanxi Medical University from June 2022 to April 2023 were selected as the research objects.Clinical data of patients were collected, and the MTHFR gene C677T locus and ACE gene I/D genotype were detected using timeof flight mass spectrometry. The patients were divided into case group and control group based on presence or absence of MCI.Multivariate Logistic regression analysis was used to analyze the influencing factors of MCI in elderly patients with hypertension.Results There were 43 cases in the case group and 37 cases in the control group. The homocysteine (Hcy) level in the case groupwas higher than that in the control group (P < 0.05) . There were significant differences in the MTHFR gene C677T locus andACE gene I/D genotype between the two groups (P < 0.05) . Multivariate Logistic regression analysis showed that Hcy, MTHFRgene C677T locus TT genotype were the influencing factors of MCI in elderly patients with hypertension (P < 0.05) . ConclusionElevated Hcy, MTHFR gene C677T locus TT genotype are risk factors for MCI in elderly patients with hypertension. Noassociation was found between ACE gene I/D genotype and MCI in elderly patients with hypertension.

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