ACE基因I/D多态性与子痫前期高血压和肾脏损害关系的研究

The relationship between the ACE gene I/D polymorphism and hypertension and renal impairing in preeclamptic patients

目的探讨血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性与子痫前期患者高血压和肾脏损害程度的相关性。方法选择子痫前期患者82例,正常孕妇45例,利用多聚酶链反应(PCR)分析其外周血白细胞中ACE基因多态性,计数两组孕妇ACE基因型和等位基因分布频率,比较不同基因型子痫前期患者高血压程度和肾功能。结果根据插入/缺失片段的有无,将ACE基因分为DD、ID、II三种基因型,子痫前期患者和正常孕妇ACE基因型和等位基因频率无统计学差异。子痫前期患者中携带D等位基因孕妇的收缩压和舒张压呈升高趋势,血清尿酸含量显著增加,但肌酐、尿素氮水平无统计学差异。结论ACE基因与子痫前期肾脏损害密切相关,携带D等位基因的子痫前期患者肾脏损害严重,血压也有升高趋势,提示D等位基因可能是子痫前期患者病情加重的不利因素。

Objective To investigate whether the insertion/deletion （I/D） polymorphisms of Angiotensin- converting enzyme （ACE） gene was associated with hypertension and renal impairing in preeclamptic （PE） patients. Methods A case - control study was conduced including 82 PE patients and 45 normal pregnancies. The polymor- phism of ACE gene was determined by polymerase chain reaction （PCR）. The frequency of the genotypes and alleles of ACE gene was compared between the preeclamptic and normal pregnancies. The level of systolic pressure, diastolic pressure, plasma creatinine, urea nitrogen and uric acid were compared by the genotypes in the preeclampsia groups. Results No significant difference in the alleles and genotypes of the ACE gene was found between the preeclamptic patients and the controls. The level of systolic pressure and diastolic pressure was highest in the DD genotypes, lightest in the II genotypes, moderate in the ID genotypes, although no significant difference was found. Serum uric acid was significant higher in preeclamptic patients with D alleles than those without D, but no significant difference was found in plasma creatinine and urea nitrogen. Conclusion The ACE gene I/D polymorphism is associated with the severity of hypertension and renal impairing in preeclamptic patients. D allele is closely related to elevation of serum uric acid and blood pressure. These findings remain further investigation in larger scale, and may provide an potential marker for risk assessment of preeclamptic patients.