ACE基因多态性及循环中酶活性与EHT的关系及赖诺普利对其疗效的观察

The Correlation of ACE Gene Polymorphism and Serum Enzyme Activity with Essential Hypertension and Its Response to Lisinopril

对１１０例原发性高血压（ＥＨＴ）患者和１６３例正常对照者取血测定其血管紧张素转换酶（ＡＣＥ）基因Ｉ与 Ｄ多态性及循环中酶活性。高血压组Ｄ等位基因频率高于对照组，分别为 ０．５１８ ２和０．４３２ ５（Ｐ＜０．０５）。两组中ＡＣＥ活性均存在ＤＤ＞ＩＤ＞Ⅱ。高血压组及对照组ＩＤ型ＡＣＥ活性分别为３１４．１±６７．９４和２５８．３５±６４．１１（Ｐ＜０．０１），Ⅱ型分别为２５９．６８±６９．６８和２２０．８８±６２．８５（Ｐ＜０．０５）。高血压组应用赖诺普利后各基因型患者血压均有明显下降，降压幅度ＤＤ＞ＩＤ＞Ⅱ。结果显示ＡＣＥ基因多态性与原发性高血压有密切关系，ＤＤ型有高易患性。ＡＣＥ活性受基因型控制，ＤＤ型活性最高。应用赖诺普利后各基因型血压均有下降，降压幅度 ＤＤ＞ ＩＤ＞ Ⅱ。 ＤＤ型可作为ＡＣＥ抑制剂应用的最佳指征。

The angiotensin-converting enzyme(ACE)gene I/D polymorphisms and serum enzyme activities were measured in 110 essential hypertension (EH) patients and 163 normal controls. Lisinopril was given to all EH patients for 12 weeks. D allele frequency of EH patients was higher than that of the normals, 0.521 8 and 0.432 5 respectively(P < 0.05 ). The ACE enzyme activities were found DD> ID> II. Enzyme activity of ID genotype was higher in EH patients than in normals, 314.1 ±67.94 and 258. 35± 64.11 respectively(P< 0.01 )and that of II genotypes was 259.68±69.68 and 220. 88 ± 62. 85 respectively(P < 0.05 ). Blood pressure, both SAP and DBP were decreased in all genotypes after the use of lisinopril, especially in DD genotype. In conclusion, I/D polymorphism of ACE gene was correlated with EH and controlled serum enzyme activity. DD genotype strongly indicated for use of ACE inhibitors.