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氯沙坦逆转高血压病人左心室肥厚与血管紧张素转化酶基因多态性的关系 被引量:2

Effects of Losartan on Left Ventricular Hypertrophy in Related to Polymorphism of Angiotensin Converting Enzyme Gene in Essential Hypertension
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摘要 目的 为了探讨血管紧张素转化酶 (ACE)基因多态性与高血压左室肥厚 (LVH)的关系。方法 利用外周血白细胞抽提基因组DNA、体外PCR基因扩增的方法检测 68例高血压LVH患者ACE基因第 16内含子、长度为 2 87bp的片段插入 /缺失 (I/D)多态性 ,并将患者分为DD、ID、II三种基因型。观测给予口服氯沙坦 (50mg~ 10 0mg/d、部分病例加用氢氯噻嗪 12 5mg~ 2 5mg/d) 2 0周前后患者坐位收缩压 (SBP)、舒张压 (DBP)、超声心动图左房内径 (LAD)、舒张末期室间隔厚度 (IVST)、左室后壁厚度 (PWT)、左室舒张末期内径 (LVDd)及左室重量指数 (LVMI)的变化。结果  (1) 68例高血压LVH患者中 ,ACE基因DD型 17例 (2 5% )、ID型 2 2例 (3 2 % )、II型 2 9例 (43 % ) ,D和I等位基因频率分别为 0 41和 0 59。(2 )所有患者口服氯沙坦 2 0周后 ,SBP、DBP明显下降 ;但其它观测指标却因基因型不同而呈现不同的变化。LVMI的下降幅度 ,DD型为 7 4% ,ID型为 5 2 % ,II型为 2 3 % ,DD型与ID型、II型相比 ,有显著性差异。结论  (1)ACE基因I/D多态性可能与高血压LVH有关 ,ACE基因DD型可能是高血压LVH的独立危险因子。 (2 )氯沙坦可以显著降低高血压LVH患者的血压、逆转LVH ,且以ACE基因DD型效果较好 (与ID型、II型相比 )。 Objective To investigate the relationship between the angiotensin converting enzyme (ACE) gene polymorphism and hypertensive left ventricular hypertrophy(LVH). Methods Losartan 50~100 mg/d an d hydrochlorothiazide 12 5 ~25 mg/d was administered for 20 weeks to 68 essential hypertensive LVH patients. Genomic DNA was isolated from peripheral leukocytes separated from the blood. Using the extracted DNA, a 287 bp insertion/deletion polymorphism in intron 16 of the ACE gene was identified by the polymerase chain reaction(PCR) method. Thus, the ACE gene polymorphism was classified into three genotypes: the 490 bp insertion homozygous(II) genotype, the 190 bp deletion homozygous(DD) genotype and the 490 bp insertion 190 bp deletion heterozygous(ID) genotype. The sitting systolic and diastolic blood pressure(SBP and DBP), M-mode echocardiography were performed before and after treatment, and changes in various parameters, such as the echocardiographic left atrial dimension(LAD), the left ventricular end-diastolic dimension(LVDd) and thickness of the interventricular septum(IVST)and the posterior wall(PWT) and the left ventricular mass index(LVMI) after treatment with losartan were examined. Results (1) The DD genotype was found in 17 patients (25%), the ID genotype in 22 patients (32%), and the II genotype in 29 patients (43%). The D and Ⅰ allele frequencies were 0 41 and 0 59. (2)In 68 patients, SBP and DBP were decreased significantly after treatment with Losartan. (3) LVMI was decreased significantly after Losartan and the change in LVMI was significantly greater in the DD genotype group than those in the other two groups(LVMI was decreased by 7 4% in the DD genotype group, 5 3% in ID and 2 3% in II genotype group, P<0 0 5). Conclusion (1) Losartan decreased SBP and DBP and regressed LVH. Losartan-induced regression of left ventricular hypertrophy (LVH) was significantly greater in the DD genotype group than those in the ID and II genotype groups. (2)ACE gene I/D polymorphism were related to hypertensive LVH,the DD genotype may be the independent risk factor on hypertensive LVH.
出处 《高血压杂志》 CAS CSCD 2003年第6期559-562,共4页 Chinese Journal of Hypertension
关键词 高血压 左心室肥厚 血管紧张素转化酶 基因多态性 氯沙坦 血管紧张素Ⅱ受体拮抗剂 essential hypertension left ventricular hypertroph y angiotensin-converting enzyme gene polymorphism angiotensin Ⅱ receptor antagonist losartan
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