血管紧张素转换酶基因多态性与血管紧张素转换酶抑制剂疗效的相关性

Polymorphism of the Angiotensin Converting Enzyme Gene and The Response to Angiotensin Converting Enzyme Inhibition in Hypertensive Patients

目的 研究原发性高血压 (EH)患者的血管紧张素转换酶 (ACE)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 ( 1)用ACEI对 5 17例EH患者进行为期 6周的降压治疗 ,所用药物为咪达普利或苯那普利。 ( 2 )用聚合酶链反应 (PCR)方法检测患者的ACE基因多态性 ,ACE基因有 3种表现型 :II型、DD型和DI型。 ( 3 )治疗前后及治疗过程中对患者的收缩压、舒张压和心率进行监测。结果 ( 1)在总共 5 17例患者中 ,ACE基因型为DD者有 13 2人( 2 5 5 % ) ,II者有 13 0人 ( 2 5 2 % ) ,ID者有 2 5 5人 ( 4 9 3 % )。 ( 2 )不同基因型组间的性别、年龄、体重指数及心率等的差异无统计学意义。 ( 3 )在这三组患者中 ,治疗前后收缩压的降幅分别为 ( -14 5± 12 7)mmHg ,( -14 3± 13 1)mmHgand( -14 0± 12 2 )mmHg (P =0 94) ,舒张压的降幅分别为 ( -8 7± 7 4)mmHg ,( -8 7± 7 7)mmHgand ( -8 5± 6 7)mmHg (P =0 96)。结论 本研究没有发现EH患者的ACE基因多态性与ACEI的降压疗效相关 ,据此 。

Objective To investigate the relationship between polymorphism of the angiotensin converting enzyme (ACE) gene and the blood pressure response to ACE inhibition in a hypertensive cohort. Methods Imidapril or Benazepril was administered for 6 weeks to 517 essential hypertensives. ACE gene polymorphism was examined by the polymerase chain reaction (PCR) method and the patients was classified as DD, ID and II genotype. The change in systolic and diastolic blood pressure was analysed for association with genotypes of ACE gene. Results The frequency of DD genotype was 25.5%(132 patients), the ID genotype 49.3%(255 patients) and the II genotyp 25.2%(130 patients). The systolic blood pressure reduction in the patients with DD genotype, II genotype and ID genotype were (-14.5±12.7) mmHg, (-14.3±13.1) mmHg and (-14.0±12.2) mmHg, respectively (P=0.94). The diastolic blood pressure reduction in the patients with DD genotype, II genotype and ID genotype were (-8.7±7.4) mmHg, (-8.7±7.7) mmHg and (-8.5±6.7) mmHg, respectively (P=0.96). Conclution No significant association between the ACE gene polymorphism and the response of BP reduction by ACEI was found. These results suggest that ACE genotypes do not associate to the blood pressure-lowing response to antihypertensive treatment with ACE inhibition.