原发性高血压患者血管紧张素转换酶基因多态性与左室肥厚的相关性研究

A study on the association between the ACE gene polymorphism and left ventricular hypertrophy in essential hypertensive

目的探讨原发性高血压(EH)患者血管紧张素转换酶(ACE)基因多态性与左室肥厚(LVH)的关系。方法轻、中度高血压病患者420例,测定血浆肾素活性(PRA)、血浆ACE浓度、血管紧张素Ⅱ(AngⅡ)浓度和醛固酮(ALD)浓度,同时用聚合酶链反应(PCR)法检测ACE基因的插入或缺失(I/D)多态性,用超声心动图测量舒张末期左心室内径(LVDd)、左心室后壁厚度(LVPWT)、舒张末期左心室间隔厚度(INSTd),比较不同左室构型患者ACE基因型的分布。结果420例患者中,左室构型异常者284例,其中向心性重构者占26.3%,向心性肥厚者占32.3%,离心性肥厚者占41.1%。正常左室构型、向心性重构、向心性肥厚、离心性肥厚患者血浆ALD浓度分别为(416.9±127.36)pmol/L、(379.2±117.9)pmol/L、(418.7±129.47)pmol/L和(457.1±134.29)pmol/L。不同左心室构型ACE基因型和等位基因分布差异无统计学意义。结论向心性肥厚和离心性肥厚者血浆ALD浓度显著高于其他构型者;向心性重构和向心性肥厚者收缩压高于其他构型患者;ACE基因I/D多态性与原发性高血压患者左室肥厚无相关性。

Objective To investigate whether the insertion/deletion （I/D） polymorphism of the angiotensin converting enzyme （ACE） gene was associated with left ventricular hypertrophy （LVH） in Chinese essential hypertension. Methods 420 mild-middle degree essential hypertensive were selected. Their plasma concentration of ACE, Ang]] , ALD and PRA were measured. Polymerase chain reaction （PCR） was used to examine the insertion/ deletion of ACE gene. Echocardiography was used to examine the LVDd, LVPWT and INSTd of left ventricular hypertrophy patients. Results There were 284 LVH patients of the 420 essential hypertensive,while the concentric remodeling was 26.3%, the concentric hypertrophy was 32.3 % and the eccentric hypertrophy was 41.1%. The plasma concentration of ALD in normal left ventricular configuration, concentric remodeling, concentric hypertrophy and eccentric hypertrophy patients were （416.9±127.36） pmol/L, （379.2± 117.9） pmol/L, （418.7± 129.47） pmol/L and （457.1±134.29） pmol/L respectively. There was no significant difference between four type of the left ventricular structure and the ACE genotype frequency. Conclusion The plasma concentration of ALD in concentric hypertrophy and eccentric hypertrophy patients were higher than that in other patients（ P〈0.05） ; the SBP in groups of concentric remodeling and concentric hypertrophy were higher than other patients（ P〈0.05） ; there was no association between the ACE genotype and the LVH in essential hypertensive.