血管紧张素转换酶抑制剂治疗高血压病人的疗效与血管紧张素转换酶基因多态性的关系

Relationship Between ACE I/D Gene Polymorphism and the Curative Effects of Angiotensin-converting Enzyme Inhibitor in Hypertensive Individuals

目的 探讨具不同血管紧张素转换酶基因插入 /缺矢基因型 (Angiotension convertingenzymegeneI/D geno type ,ACEI/Dgenotype)的高血压病人对血管紧张素转换酶抑制剂 (Angiotension convertingenzymeinhibitor,ACEI)治疗的反应性。方法 根据ACEⅠ /D基因多态性 ,将高血压病人分为II组 (2 0例 ) ,ID组 (2 0例 ) ,及DD组 (18例 ) ,共5 8例。使用西拉普利 2 .5mgQ .D ,两周后无效增至 5mgQ .D共 4周 ,观察降压疗效。 结果 II组显效 2例 ,有效 12例 ,总有效率 70 % ;ID组显效 8例 ,有效 8例 ,总有效率 80 % ;DD组显效 13例 ,有效 4例 ,总有效率 94%。ACEI对DD组疗效最好 (P <0 0 1) ,降压幅度最大 ,ID组次之 ,II组较差。结论 ACEI/D基因多态性可做为高血压病人选用ACEI时的参考指标之一。

Objective To investigate responses of patients with different ACE genotype to the treatment of angiotensin converting enzyme inhibitor(ACEI). Method According to ACE gene I/D polymorphism 58 patients with hypertension were divided in II( n= 20), ID( n= 20) and DD( n= 18) groups. All patients were treated with cilazapril 2.5 mg～5 mg for 4 weeks. Blood pressure was evaluated every week after treatment. Results 2 patients were markedly effective, 12 patients were effective and effective rate was 70% in II group. In ID group 8 patients were markedly effective,8 patients were effective and effective rate was 80%. In DD group 13 patients were markedly effective,4 patients were effective and effective rate was 94%. Curative effects of cilazapril was significantly higher in DD group than ID and II groups ( P <0 01). Conclusion ACE I/D gene polymorphism can be use as one of adjunctive indicators for predicting the effect of using ACEI in treatment of patients with hypertension.