四川南部汉族人群血管紧张素转换酶基因多态性对血管紧张素转换酶抑制剂抗蛋白尿作用的影响

Influence of angiotensin-converting enzyme gene polymorphism on the anti-proteinuria efficacy of angiotensin-converting enzyme inhibitor in Han nationality of southern Sichuan province in China

目的 探讨四川南部汉族人群血管紧张素转换酶(angiotensin- coverting enzyme,ACE)基因多态性与血管紧张素转换酶抑制剂治疗原发性慢性肾小球肾炎蛋白尿疗效的相关性。方法 用苯那普利治疗99例伴有蛋白尿的原发性慢性肾小球肾炎患者,疗程为3个月。用PCR方法检测ACE基因第16内含子的插入/缺失(insertion/ deletion,I/ D)多态性,比较血管紧张素转换酶抑制剂治疗前后各基因型患者尿蛋白定量下降程度的差异。结果 治疗前ACE基因DD型组尿蛋白显著高于II型组(P<0 .0 5 ) ;苯那普利治疗3月后,DD、ID型组的尿蛋白定量下降幅度明显高于II型组(P<0 .0 5 )。结论 苯那普利可以改善原发性慢性肾小球肾炎患者的尿蛋白,且降低尿蛋白的疗效与患者的ACE基因型有明显的相关性。

Objective To investigate the association between angiotensin-converting enzyme( ACE ) gene polymorphism and the reducing urinary protein efficacy of angiotensin-converting enzyme inhibitor(ACEI) in patients with primary chronic glomerulonephritis in Han nationality of southern Sichuan province. Methods Ninety-nine primary glomerulonephritis patients with urinary protein were enrolled in this study. They were treated with benazepril for at least 3 months. The ACE gene insertion/deletion(I/D) polymorphisms in intron 16 were determined by PCR. A comparison of the reducing urinary protein efficacy of benazepril was made between the patients with different ACE genotypes. Results Urinary protein excretion was significantly higher in patients with ACE DD genotype than that in patients with II genotype. After benazepril treatment for 3 months, the rates of urinary protein decline were observed. The rates of reduction of proteinuria in patients with DD genotype and ID genotype were obviously higher than that in patients with II genotype( P <0.05). Conclusion Benazepril could decline the rate of urinary protein excretion in patients with primary chronic glomerulonephritis, and significant relationship was observed between ACE gene polymorphism and the reducing urinary protein efficacy of ACEI.