血管紧张素转换酶抑制剂所致咳嗽与血管紧张素转换酶基因多态性的相关性

Relationship Between Polymorphism of Angiotensin Converting Enzyme Gene and Cough Caused by Angiotensin Converting Enzyme Inhibitors

目的:探讨原发性高血压患者在口服血管紧张素转换酶抑制剂(ACEI)后发生的咳嗽与血管紧张素转换酶(ACE)基因多态性之间的相关性。方法:应用多聚酶链反应(PCR)对口服ACEI的原发性高血压患者(包括发生咳嗽与不发生咳嗽者)ACE基因多态性进行检测,并比较两组患者服药前血清ACE水平。结果:130例患者中有51例(39.2%)发生咳嗽。咳嗽组ACE的I型等位基因及II型基因型频率分别为62.7%和54.8%,非咳嗽组分别为39.2%和21.5%,两组比较差异有显著性(P<0.05)。咳嗽组服药前血清ACE水平[(27.37±11.43)U/L]明显低于非咳嗽组[(45.21±12.56)U/L],两组血清ACE水平比较差异有显著性(P<0.001)。服药前血清ACE水平在DD基因型最高[(36.65±12.78)U/L],ID型次之[(27.84±7.11)U/L],II型最低[(23.02±8.31)U/L],3个基因型间比较差异有显著性(P<0.01)。结论:血清ACE水平及ACE基因多态性与高血压患者口服ACEI后所致的咳嗽有关。

Objective： To investigate the relationship between the polymorphism of angiotensin converting enzyme （ACE） gene and ACE inhibitor （ACEI）-induced cough in patients with primary hypertension. Methods： By polymerase chain reaction （PCR）, the polymorphism of ACE gene （including homozygous-alleles Ⅱ, DD, and heterozygous ID） were analyzed in patient with hypertension （cough group and non-cough group） after orally administration of ACEI. The serum ACE levels were also measured in the two groups. Results： 39.2% primary hypertension patients had cough caused by ACEIs. The frequencies of the Ⅰ alleles and Ⅱ genotype of ACE gene in the cough group （62.7% and 54.8%） were significantly higher than those in the non-cough group （39. 2% and 21. 5%, P〈0. 05）. The mean serum ACE activity before administration of the ACEI in the cough group [（27.37±11.43）U/L] was significantly lower than that in the noncough group [（45.21±12. 56） U/ L,P〈0. 001]. Serum ACE levels before ACEI was highest in the homozygous-alleles DD group [（36.65 12.78） U/L], secondly in the heterozygous ID group [（27.84±7. ll）U/L] and the lowest in homozygous-alleles Ⅱ group [（23.02±8.31）U/L] ,and the difference was significant among three groups （P〈0.01）. Conclusion： ACEI-induced cough was related to the serum ACE level and ACE gene polymorphism in patients with primary hypertension.