亚甲基四氢叶酸还原酶基因多态性与马来酸依那普利叶酸片疗效分析  

Gene polymorphism of MTHFR and curative effect of Enalapril Maleate-Folate Tablets

作　　者：夏洪颖[1] 章体玲[1] 王杨[1] 黄帮华[2] 李仲昆 王丽军[3] 梁月琴[1] Xia Hongying;Zhang Tiling;Wang Yang;Huang Banghua;Li Zhongkun;Wang Lijun;Liang Yueqin(Department of Pharmacy Yan'an Hospital, Kunming Medical University, Kunming 650000, China)

机构地区：[1]昆明医科大学附属延安医院药学部,昆明650000 [2]云南省第一人民医院药学部,昆明650000 [3]昆明市第一人民医院泌尿外科,昆明650000

出　　处：《中国循证心血管医学杂志》2017年第8期917-919,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：云南省应用基础研究计划项目(2013FZ287)

摘　　要：目的分析亚甲基四氢叶酸还原酶(MTHFR)基因多态性与马来酸依那普利叶酸片治疗H型高血压患者疗效的相关性。方法选取昆明医科大学附属延安医院心内科于2013年10月~2015年9月间收治的H型高血压患者168例,男性84例,女性84例。将患者随机分为观察组(85例)和对照组(83例)。对照组口服依那普利片,观察组口服马来酸依那普利叶酸片,疗程均为4周。治疗前检测所有入选者MTHFR基因型。用药前及用药4周后测定患者血浆同型半胱氨酸(Hcy)和血压。结果治疗后两组血压和Hcy较治疗前均明显下降,观察组较对照组下降更明显,差异有统计学意义(P均<0.05)。两组患者MTHFR基因型为CC、CT和TT,基因型频率比较,差异无统计学意义(P均>0.05)。治疗4周后,观察组CC、CT和TT基因型Hcy水平较对照组均有所下降,差异有统计学意义(P均<0.05)。观察组CC、CT和TT基因型Hcy水平比较,差异无统计学意义(P均>0.05)。结论马来酸依那普利叶酸片可以明显改善H型高血压患者血压及Hcy水平,疗效优于单用依那普利;不同MTHFR基因型H型高血压患者疗效无明显差异。本研究样本量较小,有待大样本研究进一步验证本结论。Objective To analyze the correlation between the gene polymorphism of methylenetetrahydrofolate reductase(MTHFR)and curative effect of Enalapril Maleate-Folate Tablets in treatment of H-type hypertension.Methods The patients with H-type hypertension(n=168,male84and female84)were chosen from the Department of Cardiology of Yan’an Hospital affiliated to Kunming Medical University from Oct.2013to Sept.2015.All patients were randomly divided into observation group(n=85)and control group(n=83).The control group wasgiven Enalapril Tablets and observation group was given Enalapril Maleate-Folate Tablets for one therapeutic course(4weeks).The genotypes of MTHFR were measured in all selectees before treatment,and the levels of plasma homocysteine(Hcy)and blood pressure(BP)were detected before and4weeks after treatment.Results The levels of BP and Hcy decreased significantly in2groups after treatment,and the decrease was more significant in observation group(all P<0.05).The genotypes of MTHFR were CC,CT and TT in the patients in2groups,and the comparison in genotype frequency showed that the difference had no statistical significance between2groups(all P>0.05).After treatment for4weeks,the level of Hcy decreased in patients with genotypes of CC,CT and TT in observation group compared with the patients in control group(all P<0.05).The comparison in Hcy level among genotypes of CC,CT and TT in patients in observation group showed that the difference had no statistical significance(all P>0.05).Conclusion Enalapril Maleate-Folate Tablets can obviously improve the levels of BP and Hcy,and its curative effect is better than that of single Enalapril Tablets in patients with H-type hypertension.The curative effect has no significant difference among patients with different genotypes of MTHFR.As the sample size is small in this study,the study with larger sample size is needed to further verify the conclusion.

关 键 词：甲基四氢叶酸还原酶 基因多态性 马来酸依那普利叶酸 H型高血压 疗效 

分 类 号：R544.1[医药卫生—心血管疾病]