ACE基因I/D和AT1R基因A1166C多态性与氢氯噻嗪降压疗效的相关性研究  

Dependability study of polymorphism of ACE and AT1R genes and the underpreasue effect of hydrochlorothiazide

作　　者：李冬青[1] 王希柱[2] 杨国强 宋绍敏[1] 李宏芬[1] 张秋芬[1] 吴寿岭[1] 

机构地区：[1]华北煤炭医学院附属开滦医院,河北唐山063000 [2]华北煤炭医学院附属唐山市人民医院 [3]王田县医院

出　　处：《山东医药》2008年第4期19-21,共3页Shandong Medical Journal

基　　金：河北省科学技术研究与发展计划项目(052761109)

摘　　要：目的探讨血管紧张素转换酶(ACE)基因I/D与血管紧张素Ⅱ-1型受体(AT1R)基因A1166C多态性与氢氯噻嗪(HCTZ)降压疗效的关系。方法原发性高血压患者服用HCTZ6周后,按不同ACE基因型和AT1R基因型分组,比较不同基因型组合患者的血压下降值。结果ACE基因DD、ID、Ⅱ基因型患者收缩压均下降,DD基因型患者收缩压下降值显著大于ID、II型患者(P<0.05);AT1R基因AC(CC)和AA基因型患者收缩压下降值组间比较无显著差异(P>0.05);DD+AC(CC)基因型组合患者收缩压亦下降,与其他基因型组合患者比较无显著差异(P>0.05)。多因素分析结果表明,治疗前醛固酮浓度和DD基因型是影响患者收缩压下降的主要因素。结论ACE基因的DD基因型与HCTZ的降压疗效相关;AT1R基因AC(CC)、DD+AC(CC)型组合患者对HCTZ的降压反应可能优于其他基因型组合患者。Objective To investigate the relation between underpreasue effect of hydrochlorethiazide （HCTZ） and angiotensin converting enzyme （ACE） gene I/D and angiotensin II type 1 receptor（ATIR） Al166C polymorphism. Methods After primary hypertension patients took HCTZ for six weeks, groups were divided by ACE genetype and AT1R genetype, blood pressure degression value of different genotypic combination patients were compared. Results The systolic pressure of ACE gene DD, ID, Ⅱ genotypic patients all reduced, the systolic pressure reduction values of DD genotypic patients were obviously higher than that of ID, Ⅱ genotypic patients （ P 〈 0.05）. There was no difference in the systolic pressure reduction values between ATIR AC （CC） genotypic patients and ATIR AA genotypic patients （ P 〉 0.05 ）. The systolic pressure of DD ＋ AC（ CC）genotypic patients reduced as well, but it had no difference compared with that of other genotypic combination patients （ P 〉 0.05）. Multiplicity results indicated density of aldosterene and DD genetype before treatment was the chief influential factor of systolic pressure reduction in patients. Conclusion ACE DD genotype is associated with the reducing pressure effect of HCTZ; The subjects with the combination of ACE DD and ATIR AC（CC） genotype might have a better response of reducing pressure to HCTZ than that of the other genotypic combination patients.

关 键 词：高血压 ACE基因 AT1R基因 基因多态性 治疗结果 氢氯噻嗪 

分 类 号：R544.1[医药卫生—心血管疾病]