肾实质性高血压患者血管紧张素转换酶基因多态性与血管紧张素转换酶活性的研究  

Relationship between angiotensin Ⅰ converting enzyme gene insertion/deletion polymorphism and serum ACE activity in patients with renal parenchymal hypertension

作　　者：曾文[1] 吴文成[1] 王彦[1] 傅淑霞[1] 

机构地区：[1]河北医科大学第二医院肾内科,河北石家庄050000

出　　处：《临床荟萃》2007年第1期13-16,共4页Clinical Focus

摘　　要：目的研究肾实质性高血压患者血管紧张素转换酶(ACE)基因多态性及与ACE活性的关系。方法运用聚合酶链反应技术检测78例肾实质性高血压患者血管紧张素转换酶插入/缺失基因多态性,采用紫外分光光度法测定ACE活性,以87例正常人为对照。结果①患者组基因型分布与对照组不同(P<0.05),其中缺失型(DD型)频率升高(43.6%vs24.1%,P<0.01);②DD型、缺失/插入型(DI型)、插入型(II型)酶活性在对照组分别为(33.8±12.0)U/L、(18.6±7.2)U/L、(13.4±5.0)U/L,在患者组分别为(31.1±10.2)U/L、(26.3±8.0)U/L、(18.4±7.5)U/L,均表现DD型最高,II型最低(均P<0.01);③患者组ACE活性明显高于对照组(25.9±10.4)U/Lvs(20.7±11.2)U/L(P<0.01);两组ACE活性DD型间差异无统计学意义(P>0.05),而DI型间和II型间患者组明显高于对照组(均P<0.01)。结论①DD基因型在肾实质性高血压患者分布频率升高,是高危因素,与其ACE活性增高有关;②肾实质性高血压患者ACE活性升高,增高程度与基因型有关;因此基因型和ACE活性的检测可作为指导治疗的指标。Objective To investigate the relationship between angiotensin Ⅰconverting enzyme （ACE） gene insertion/deletion polymorphism and serum enzyme activity in the patients with renal parenchymal hypertension. Methods ACE insertion/deletion gene polymorphism was determined with polymerase chain reaction amplification and ACE activity was measured by using ultraviolet photometry in 78 patients with renoparenchymal hypertension and in 87 health subjects as controls. Results （ Compared with control group, genotype frequency distribution was significantly different in renoparenchymal hypertension group （ P 〈 0.05）, and DD genotype frequency was higher （43.6 % vs 24.1%, P 〈 0.01） . （2） ACE activities for DD, DI, II genotype in the controls were （33.8±12.0） U/L, （18.6±7.2） U/L, （13.4±5.0） U/L respectively, and in the patients were （31. 1±10.2） U/L, （26.3± 8.0） U/L, （18.4±7.5） U/L respectively, DD genotype showed the highest levels,whereas II showed the lowest levels; （3）ACE activity was higher in the patients than in the controls （25.9±10.4） U/L vs （20.7±11.2） U/L（ P 〈0.01） ; There was no difference in DD genotype （P〉 0. 05）, but ACE activity in DI and Ⅱgenotype were significant higher respectively （ P 〈0.01）. Conclusion （1）ACE gene polymorphism was associated with renoparenchymal hypertension, DD genotype may be a high risk factor for its highest activity. （2） ACE activity was higher in renoparenchymal hypertension patients, which in different genotype had different increase. Therefore detection of ACE genotype and serum ACE activity may be good markers to ACE inhibitors treatment in renoparenchymal hypertension patients.

关 键 词：肽基二肽酶A 高血压 肾性 基因多态性 

分 类 号：R544.1[医药卫生—心血管疾病] R394.3[医药卫生—内科学]