AⅡ_1R基因1 166位点多态性与AⅡ受体拮抗剂缬沙坦降压疗效关系的研究  

The relationship between AⅡ_1 receptor gene polymorphism and the effect of treatment of hypertension with AⅡ receptor antagonist-Valsartan

作　　者：林欣[1] 江时森[1] 曹文[2] 徐燕丰[2] 汪春晖[2] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院心内科,江苏南京2100021 [2]南京大学医学院临床学院南京军区南京总医院药理科,江苏南京2100021

出　　处：《医学研究生学报》2002年第2期135-139,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金资助课题 ( 39970 863)

摘　　要：目的 :探讨血管紧张素Ⅱ 1型受体 (AⅡ1R)基因A 1166/C多态性与国人应用AⅡ受体拮抗剂缬沙坦降压疗效的关系 ,以利于结合基因分型指导临床合理用药的可行性。　方法 :64例轻、中度原发性高血压患者住院期间停止服用任何降压药物 5个半衰期后 ,测量患者基础血压 ,并抽取血样 ,应用限制性内切酶酶解聚合酶链式反应(PCR RFLP)的方法检测AⅡ1R基因型。然后给予缬沙坦 80mg ,1次 /d ,连续服用 10天 ,分别于第 7、10天上午9:0 0测量患者卧位、左上臂血压。　结果 :CC基因型因其突变率极低 ,本次试验未发现 ,故未予以分组。①本组原发性高血压患者AC基因型频率为 2 3 .4 % ,C等位基因频率为 11.7%。②入选 64例原发性高血压患者 ,服药后 ,显效 5 2例 ,有效 10例 ;无效 2例 ,已剔除 ,未参与统计。AC基因型组有效率为 93 .3 3 % ,AA基因型组有效率为97.96% ,总有效率为 96.88% ,AC基因型组与AA基因型组之间有效率无明显差异 (P >0 .0 5 )。③患者服用缬沙坦后第 7天、第 10天AC基因型组收缩压下降值均较AA基因型组有极显著差异 (P <0 .0 1)。④患者服用缬沙坦后第 7天 ,AC基因型组舒张压下降值较AA基因型组差异显著 ( 0 .0 1<P <0 .0 5 )。而第 10天时两基因型组舒张压下降值差异不明显 (P >0 .0 5 )。⑤患者服?Objectives:To investigate the relationship between AⅡ 1 receptor gene polymorphism and the effect of treatment of hypertension with AⅡ receptor antagonist-Valsartan, in order to guide the choice of anti hypertensive drugs according to A 1 receptor gene classification. Methods: Sixty four patients of mild moderate essential hypertension did not receive any anti hypertensive drugs for 5 half lives, then PCR RFLP was applied to detect AⅡ 1 receptor gene types and basal blood pressure was measured concomitantly. After that, all patients received Valsartan (80 mg/qd) for 10 days. Patients' blood pressure were measured at 9:00 in the 7th and 10th days. Results:① The frequency of AC gene type and the C1166 allete of AⅡ 1 receptor gene was 23.4% and 11.7%.② Among patients with essential hypertension, Valsartan was highly effective in 52 cases, effective in 10 cases, and non responsive in 2 patient. The efficiency of AC and AA gene type were 93.33% and 97.96%. The total efficiency was 96.88 %. The efficiency between AC and AA gene type were not different significantly( P >0.05). ③There was a remarkable decrease of SBP( P <0.01) between AC and AA gene type on the 7th and the 10th day. ④There was an obvious decrease of DBP between the two groups (0.01< P <0.05) on the 7th day, but not different significantly on the 10th day ( P >0.05).⑤ There was an obvious decrease of pulse pressure on the 7th day (0.01< P <0.05), and a highly remarkable decrease ( P <0.01) on the 10th day between AC and AA gene type. Conclusions:The effect of Valsartan to decrease SBP and pulse pressure in AC and AA gene type is superior to AA gene type; At the early period(within 7 days),the effect of Valsartan to decrease DBP in AC gene type is better than AA, but there was no difference on the 10th day between the two groups. We concluded that Valsartan was protective to the target organs in AC gene type patients. Based upon this, gene classification was directive to the clinical selec

关 键 词：原发性高血压 AⅡ1R基因 基因多态性 AⅡ受体拮抗剂 缬沙坦 治疗 

分 类 号：R544.1[医药卫生—心血管疾病]