伊贝沙坦对不同ACE基因多态性肾病病人疗效对比  

Irbesartan in Treatment of Nephropathy with Different ACE gene I/D Polymorphism

作　　者：吴涛[1] 关广聚[1] 吴文秀[1] 付玉芹[1] 姚晓奕[2] 

机构地区：[1]山东大学第二医院肾内科,济南250033 [2]山东省交通医院,济南250032

出　　处：《中国临床药理学杂志》2002年第4期272-273,280,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探讨血管紧张素Ⅱ（Ang Ⅱ）受体拮抗剂对不同血管紧张素转换酶（ACE）基因肾病患者疗效有无差异。方法:分别检测糖尿病肾病8例,高血压肾病9例,慢性肾功能衰竭12例病人的ACE基因I/D多态性。实验前2个月病人禁用血管紧张素转化酶抑制剂（ACEI）。原治疗方案不变,在服药前查24h尿蛋白定量、血肌酥（Cr）、尿素氮（BUN）。之后给予血管紧张素Ⅱ受体拮抗剂-伊贝沙坦150mg,每日一次口服,共8周,结束后复查上述三个项目。结果:三种基因型肾病患者治疗前各项指标比较无显著性差别,治疗后比较亦无差别但同一病人治疗前后24h尿蛋白定量比较均有显著性差别（P<0.05）,治疗后尿蛋白明显减少。血肌酐及尿素氮治疗前后则无明显差别。29例病人均未出现明显不适。结论Ang Ⅱ受体拮抗剂治疗肾脏疾病降低尿蛋白的作用与ACE基因I/D多态性无关,即伊贝沙坦对三种ACE基因型肾病病人降尿蛋白均有显著作用且耐受性良好。OBJECTIVE: To investigate therapeutic effectiveness of Irbesartan in treatment of nephropathy with different angiotensin converting enzyme(ACE)gene I/D polymorphism METHODS: 8 patients with diabetic nephropathy(DN),9 patients with primary hypertension nephropathy, 12 patients with chronic renal failure were involved in this study. ACE gene I/D polymorphism was dectected by polymerase chain reaction(PCR) amplification of DNA fragment. All patients were treated with Irbesartan(Aprovel)for 8 weeks. RESULTS: After treatment, the clinical therapeutic effect between pre- and post-treatment group were obviously of significance(P<0.05) but there were not difference among the three kinds of genotype patients after treatment. CONCLUSION: Irbesartan has obvious clinical effect on the nephropathy but the effect was not correlative with patientis ACE gene polymorphism.

关 键 词：基因多态性 疗效 ACE基因型肾病 伊贝沙坦 血管紧张素转换酶基因 尿蛋白 

分 类 号：R692[医药卫生—泌尿科学] R972[医药卫生—外科学]