血管紧张素转换酶基因型与氢氯噻嗪降压疗效的相关性研究  

Study on the correlation of angiotensin converting enzyme genotypes with the antihypertensive effects of hydrochlorthiazide

作　　者：吴寿岭[1] 周永[1] 刘秀荣[1] 于清[1] 程凯[1] 幺太成[1] 王志斌[1] 宋绍敏[1] 王黎光[1] 李军[1] 

机构地区：[1]华北煤炭医学院附属开滦医院,唐山063000

出　　处：《中华心血管病杂志》2004年第4期295-299,共5页Chinese Journal of Cardiology

摘　　要：目的　探讨高血压病患者血管紧张素转换酶 (ACE)基因不同基因型与氢氯噻嗪降压疗效的关系。方法　 5 18例高血压病患者同时服用氢氯噻嗪 12 5mg ,每日 1次 ,共 6周。资料完整的 5 0 4例患者按II、ID、DD三种基因型分组 ,比较不同基因型间的降压疗效。结果　II、ID、DD基因型患者收缩压下降值分别为 5 7mmHg(1mmHg =0 133kPa)、5 1mmHg、10 4mmHg ,DD基因型患者收缩压下降值大II、ID两型患者 ,差异具有统计学意义 (P <0 0 5 ) ;三组间舒张压下降值、平均动脉压下降值差异无统计学意义 (P >0 0 5 ) ;多元线性回归结果表明DD基因型、治疗前醛固酮水平、血钠水平是影响收缩压下降值的主要因素。结论　不同ACE基因型患者对氢氯噻嗪的反应存在差异 ,DD基因型患者收缩压下降最明显。Objective To study the correlation of angiotensin converting enzyme (ACE) genotypes with the antihypertensive effects of hydrochlorthiazide (HCTZ) in hypertensive patients. Methods A total of 518 patients were on HCTZ 12.5 mg (once daily) for six weeks. 504 patients with complete records were grouped into II, ID and DD genotypes, and antihypertensive effects were compared among different ACE genotypes. Results After 6 weeks′ treatment, the decrease in SBP of patients carrying DD was greater than that in other groups carrying II or ID(10.4 mm Hg vs 5.7 mm Hg, 10.7 vs 5.1 mm Hg, respectively, P<0.05); There was no significant difference in the decrease of DBP or MAP among these three groups. Multivariate linear regression analysis showed that, the DD genotype, the baseline ALD and serum sodium levels were the three major factors affecting the decrease in SBP. Conclusion Hypertensive patients carrying different ACE genotypes responded differently to HCTZ, and those carrying DD genotype showed a most significant reduction in SBP.

关 键 词：血管紧张素转换酶 基因型 氢氯噻嗪 降压疗效 相关性 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]