肾素-血管紧张素系统与血管紧张素转换酶基因多态性的关系

Relationship between renin-angiotensin system and angiotensin converting enzyme gene polymorphism

目的 了解血管紧张素转换酶 (ACE)基因多态性对肾素 血管紧张素系统 (RAS)的影响。方法 6 8例高血压患者给予口服氯沙坦钾 5 0～ 10 0mg/d ,共 2 0周。采用外周血白细胞抽提基因组DNA、体外PCR基因扩增的方法检测ACE基因第 16内含子、长度为 2 87bp的片段插入 /缺失 (I/D)多态性 ,并将患者分为DD、ID、II这 3种基因型。采用放射免疫分析法检测治疗前后患者血浆肾素活性 (PRA)、血管紧张素Ⅱ (AⅡ )、血清醛固酮 (ALD)的变化。结果 口服氯沙坦钾2 0周后 ,6 8例患者ALD明显下降 ,PRA和AⅡ明显升高 ,但基因型不同其变化明显不同。结论 ACE基因I/D多态性对RAS有明显的影响。

Objective To investigate the relationship between renal angiotensin system(RAS) and the angiotensin converting enzyme (ACE) gene polymorphism. Methods Losartan 50～100 mg/d was administered to 68 essential hypertensive patients for 20 weeks. Genomic DNA was isolated from peripheral leukocytes separated from the blood. Using the extracted DNA, a 287 bp insertion/deletion polymorphism in intron 16 of the ACE gene was identified by the polymerase chain reaction(PCR) method. Thus, the ACE gene polymorphism was classified into three genotypes: the 490 bp insertion homozygous(Ⅱ) genotype, the 190 bp deletion homozygous(DD) genotype and the 490 bp insertion 190 bp deletion heterozygous(ID) genotype. The levels of serum renin activity(PRA), angiotensin Ⅱ(AⅡ), aldosterone(ALD) before and after treatment with losartan were detected with radioimmunoassay(RIA). Results In a total of 68 patients, the level of ALD was decreased and the levels of PRA and A Ⅱ were elevated significantly after treatment with Losartan, but there were different changes if genotypes were concerned. Conclusion ACE gene I/D polymorphism has significant influences on RAS.