老年高血压患者ACEI/D基因多态性与ACE抑制剂疗效的相关性

Relationship between ACEI / D gene polymorphism and curative effects of angiotensinconverting enzyme inhibitor in elderlyhypertension patients

目的探讨老年高血压患者ACE I/D基因多态性与血管紧张素转换酶抑制剂(ACEI)疗效的相关性。方法选取108例老年高血压未经降压治疗的患者;应用聚合酶链反应(PCR)方法检测其ACE I/D基因多态性,有三种表现形式:II型、DD型和ID型,根据其基因多态性分为三组,对所有高血压患者均给予卡托普利口服6周。治疗前后及治疗过程中对患者的血压进行监测。结果 (1)108例高血压患者中II基因型频率为27%;ID型为33%;DD型为40%;(2)II组显著有效4例,有效14例,总有效率61%;ID组显著有效8例,有效18例,总有效率73%;DD组显著有效29例,有效11例,总有效率93%。卡托普利对DD组疗效最好(P<0.05),ID组次之,II组较差。结论 ACE I/D基因多态性可做为老年高血压病人选用ACEI时的参考指标之一。

Objective To explore the relationship between the ACE geneinsertion /deletion （ I/D ） polymorphism and the curative effects of angiotensin-converting enzyme inhibitor （ ACEI ） in elderly patients with hypertension.Methods Polymerase chain reaction（PCR） technique was used to detect ACE I/D polymorphism in 108 subjects of elderly hypertensionpatients who received no therapy ever , and the patients were classified as II, ID and DD genotype .Meanwhile captopril was administered for 6 weeks to all patients .Measure the blood pressure of all patients during the treatment and post treatment .Results The frequency of II genotype was 27%, the ID genotype was 33%and the DD genotype was 40%.4 patients in II group were markedly effective and 14 patients were effective , the effective rate was 61%.In ID group, 8 patients were markedly effective and 18 patients were effective , effective rate was 73%.In DD group 29 patients were markedly effective , 11 patients were effective , effective rate was 93%.Curative effect of captoprilwas significantly higher in DD group than in ID and II group（P〈0.05）.Conclusions ACE I/D gene polymorphism can be use as one of adjunctive indicators for predicting the effect of using ACEI inelderly patients with hypertension .