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目的研究血管紧张素转换酶（ＡＣＥ）基因的插入多态性与糖尿病合并高血压脑卒中发病的关系。方法应用ＰＣＲ扩增方法鉴定５０例糖尿病并高血压脑卒中患者、６９例糖尿病无血管病变患者和８５例健康对照者的ＡＣＥ基因多态性。结果糖尿病并高血压脑卒中患者ＡＣＥ基因的插入／插入纯合型频率（４６％）明显高于对照组（３０％）（＜Ｐ０．０５）；插入／缺失杂合型及缺失／缺失纯合型的频率（分别为２８％和４８％）与对照组（分别为２６％和２２％）差异无显著性（均为Ｐ＞０．０５）。糖尿病无血管并发症患者ＡＣＥ基因各型与对照组差异无显著性（均为Ｐ＞０．０５）。脑ＣＴ扫描显示基因插入／插入纯合型的糖尿病并高血压脑卒中患者中，７６％有多发腔隙性脑梗塞。结论ＡＣＥ基因插入／插入纯合型与脑卒中发病相关。
Objective To investigate the relationship between the insertion polymorphism of angiotensin converting enzyme (ACE) gene and the incidence of stroke complicated by hypertension and hypertension. Methods PCR amplification was used to identify ACE gene polymorphisms in 50 patients with diabetes mellitus and hypertensive stroke, 69 patients with diabetes mellitus without vascular disease and 85 healthy controls. Results The insertion / insertion homozygous frequency (46%) of ACE gene in patients with diabetes mellitus and hypertensive stroke was significantly higher than that in the control group (30%) (P <0.05). The insertion / deletion heterozygosity and deletion / deletion homozygosity (28% and 48%, respectively) and controls (26% and 22%, respectively) had no significant difference (all P> 0.05). There was no significant difference in the ACE gene polymorphism between diabetic patients with vascular complications and the control group (all P> 0.05). Brain CT scans showed 76% of patients with multiple lacunar infarcts in genetically inserted / inserted homozygous diabetic patients with hypertensive stroke. Conclusion ACE gene insertion / insertion homozygosity is associated with stroke.