血管紧张素转换酶基因多态性对口服美托洛尔的高血压患者疗效的影响

Influence of angiotensin-converting enzyme polymorphism on the responses to metoprolol in hypertensive patients

目的研究血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性对美托洛尔(β1肾上腺素受体阻滞剂,抗高血压药)治疗高血压疗效的影响。方法用美托洛尔100mg.d-1单药治疗原发性高血压患者,疗程8周;治疗前后,均进行动态血压和动态心电监测;用PCR-RFLP方法分析ACE基因I/D多态性。结果治疗后,血压和心率明显下降(P<0.05);24h平均心率,在携带II多态性的患者是(67.6±6.6)次/分,在携带ID型和DD型患者是(70.9±7.3)次/分(P=0.045)。治疗前后,24h平均心率的差值分别是(8.73±8.16),(5.46±6.28)次/分(P=0.046)。结论 ACE基因I/D多态性可影响美托洛尔治疗后24h平均心率变化。

Objective To study the influence of angiotensin - converting enzyme （ACE） gene insertion/deletion （I/D） polymorphism on the responses to metoprolol in hypertensive patients. Methods Patients received metoprolol （ 100 mg once daily） as monotherapy for 8 weeks. Before and after treatment, 24 - hour ambulatory blood pressure monitoring （ABPM） and dynamic electrocardiogram （DCG） were performed. Genotyping analysis was conducted by PCR RFLP assay. Results After 8 - week treatment, significant difference was detected in 24 -hour average heart rate [ （67.6 ± 6.6 ） beats min - 1 in II group vs （70.9 ± 7.3 ） beats·min^-1 in D^＋ group, P = 0. 045 ]. The difference during the treatment was （8.73 ±8.16） beats · min^-1 in II group vs （5.46 ±6.28） beats · min^-1 in D ^＋ group （P = 0. 046）. Conclusion The ACE gene I/D genotype affected metoprolol - induced reduction in 24 - hour average heart rate.