摘要
目的研究血管紧张素转换酶（angiotensin—converting enzyme，ACE）基因多态性与依那普利降压疗效的相关性。4方法采用聚合酶链式反应一限制性片断长度多态性（polymerase chain reaction—restriction fragment length polymorphism，PCR—RFLP）对68例原发性高血压患者进行ACE基因型分析，根据ACE三种基因型DD型、ID型和Ⅱ型将受试者分为三组，所有受试者每天服用依那普利20mg进行2周的降压治疗，观察依那普利在三种不同ACE基因型中的降压疗效及差异。结果在所有68例原发性高血压患者中，依那普利治疗前与治疗后每组收缩压和舒张压的降低均有显著性（P〈0．05），其中DD型与Ⅱ型两组之间的收缩压和舒张压降压幅度（即治疗前与治疗后血压的差值）有统计学意义（P〈0．05）。DD组依那普利的总有效率为91．30％；ID组为85．71％；Ⅱ组是79．17％。依那普利对DD组疗效最好，ID组次之，Ⅱ组较差。结论原发性高血压患者中血管紧张素转换酶基因多态性与依那普利降压疗效相关。
Objective To investigate the relationship between the theraputic effect of enalapril on blood pres- sure reduction and ACE genetic polymorphism. Methods The genotypes of ACE in 68 patients with essential hyperten- sion were determined by polymerase chain reaction - restriction fragment length polymorphism （PCR- RFLP） assay. All subjects were randomly divided into three group （ group DD, group Ⅱ, and group ID） according to their different ACE genotypes. The 68 patients with essential hypertension were treated with 20 mg enalapril daily for 2 consecutive weeks. The changes of systolic and diastolic blood pressure in all subjects were observed before and after enalapril administra- tion. Results Our data showed that there were significantly statistical differences in the systolic blood pressure and dias- tolic blood pressure in the three groups＇ patients with essential hypertension between before and after enalapril administra- tion （ P 〈 0.05 ） . Additionally, there was marked difference in the differential values of systolic blood pressure and dias- tolic blood pressure reduction between group DD and group II （ P 〈 0.05 ） . The total efficacy rate of enalapril treatment were 91.30% in group DD, 85.71% in group ID, and 79.17% in group Ⅱ respectively, which indicated that enalapril had the best effect on blood pressure reduction in DD genotyped group. Conclusion The theraputic effects of enalapril on blood pressure reduction are associated with ACE genetic polymorphism and the essential hypertensive patients, with DD genotypes had the best response to the enalapril treatment compared with ID genotypes and II genotypes.
