哮喘患者青春期自然缓解时气道反应性及有关因素的变化

Association between ACE gene polymorphism and therapeutic responsiveness of ACEI in diabetic nephropathy

目的阐明哮喘儿童到青春期病变自然缓解的气道反应性及其有关因素。方法采用乙酰甲胆碱支气管激发试验判定气道反应性（ＰＣ２０）并检测血可溶性白细胞介素２受体（ｓＩＬ２Ｒ）、嗜酸性粒细胞数值、嗜碱性粒细胞数值及嗜碱性粒细胞释放介质的能力，分别对１８例青春期哮喘自然缓解者、２０例未缓解者和３０例正常人进行比较。结果（１）自然缓解组的ＰＣ２０值（６±６ｇ／Ｌ）显著低于正常人（１００±３６ｇ／Ｌ），但仍显著高于未缓解组（１０±１４ｇ／Ｌ）；（２）自然缓解组ｓＩＬ２Ｒ值、嗜酸性粒细胞值与正常人接近；（３）自然缓解组嗜碱性粒细胞值及对高参的释放能力，仍明显高于正常人，嗜碱性粒细胞数值与气道反应性呈显著负相关。结论哮喘青春期缓解者气道仍存在着一定程序的高反应性。

Ojective To clarify the association between ACE gene polymorphism and therapeutic responsiveness of ACEI in diabetic nephropathy. Method With the polymerase chain reaction technique,the angiotensin converting enzyme (ACE) gene insertion /deletion(I/D) polymorphism was studied in 31 NIDDM patients,58 NIDDM patients with nephropathy, and 50 normal controls. Results There was no significant difference in the frequency of ACE genotypes among those NIDDM patients,NIDDM patients with nephropathy and nomal controls. Among 40 patients of DN group treated with ACE inhibitor(ACE Ⅰ), there was significant difference in genotype distribution between 19 efficacious cases and 21 nonefficacious cases: 8/2/9 vs 1/3/17 had DD/DI/Ⅱ genotypes responsively ( P <0 01),DD genotype was best and Ⅱ genotype was worst in therapeutic efficacy of ACE Ⅰ in NIDDM patients with nephropathy. Conclution The examination of ACE gene polymorphism is helpful for the diagnosis of the therapeutic efficacy of ACE Ⅰ in NIDDM with nephropathy.