长期服用苯那普利的高血压患者左室肥厚逆转与血管紧张素转换酶基因和Chymase基因多态性的相关性研究

和红; 李立明; 曹卫华; 刘美贞; 孙宁玲; 吕筠; 胡永华

Abstract

和红,李立明,曹卫华,刘美贞,孙宁玲,吕筠,胡永华.长期服用苯那普利的高血压患者左室肥厚逆转与血管紧张素转换酶基因和Chymase基因多态性的相关性研究[J].Chinese journal of Epidemiology,2004,25(9):756-760

长期服用苯那普利的高血压患者左室肥厚逆转与血管紧张素转换酶基因和Chymase基因多态性的相关性研究

Association between angiotensin converting enzyme gene, chymase gene and regression of left ventricular hypertrophy in patients treated with angiotensin converting enzyme inhibitors

DOI：

KeyWord: 高血压|盐酸苯那普利|左室肥厚逆转|基因，血管紧张素转换酶|基因，Chymase

English Key Word: Hypertension, essential|Benazepril|Left ventricular hypertrophy|Gene, regression angiotensin converting enzyme|Gene, chymase

FundProject:国家“九五”科技攻关基金资助项目(96-906-02-05)

Author Name	Affiliation
HE Hong	Department of Epidemiology and Biostutistics, School of Public Health, Peking University, Beijing 100083, China
LI Li-ming	中国疾病预防控制中心
Cao Wei-hua	Department of Epidemiology and Biostutistics, School of Public Health, Peking University, Beijing 100083, China
LIU Mei-zhen	北京大学附属人民医院心内科
SUN Ning-ling	北京大学附属人民医院心内科
LV Jun	Department of Epidemiology and Biostutistics, School of Public Health, Peking University, Beijing 100083, China
HU Yong-hua	Department of Epidemiology and Biostutistics, School of Public Health, Peking University, Beijing 100083, China

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Abstract:

目的讨长期服用苯那普利的原发性高血压患者左室肥厚逆转与血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性和Chymase(CMA)基因A/B多态性的关系. 方法收集157例原发性高血压伴左室肥厚患者24个月的随访资料; 应用聚合酶链反应和限制性片段长度多态性方法检测ACE基因I/D多态性以及CMA基因A/B多态性; 超声心动测量左室舒张末期内径(LVDd)、舒张期室间隔厚度(IVST)及左室后壁厚度(LVPWT). 结果 (1)治疗后血压明显下降而心率改变不明显; (2)能明显逆转LVH; (3)ACE基因型间除左室质量(LVM)下降值及左室质量指数(LVMI)下降值在DD基因型明显大于II型和ID型以外, 其余各临床指标下降值在ACE基因型间的差异均无统计学意义; (4)CMA基因型间各临床指标下降值的差异均无统计学意义; (5)ACE基因中各基因型与CMA基因中各基因型间不存在交互作用; (6)多元线性逐步回归分析表明, 仅ACE基因型与LVMI下降值有关. 结论长期服用苯那普利可以明显降低血压、逆转LVH; 其中ACE基因为DD型的患者较其他基因型患者更易于LVH逆转, 而CMA基因多态性与LVH逆转不相关; 两种基因间不存在交互作用.

English Abstract:

Objective To investigate the association between insertion/deletion(I/D) polymorphism of the angiotensin converting enzyme (ACE) gene and the州B polymorphism of the chymase (CMA) gene with regression of left ventricular hypertrophy(LVH) in patients with essential hypertension and left ventricular hypertrophy. The study subjects had been participants in a long-term trial of therapy with an. ACE inhibitor. Methods Follow-up data of 157 patients with essential hypertension and left ventricular hypertrophy were collected. DNA fragments of ACE gene and CMA gene were amplified by PCR and analysed by RFLP. LVDd, IVST and LVPWT were measured by Ultrasonic Cardiogram (UCG). Results (1)When long-term treatment with Benazepril was carried out, the blood pressure was markedly decreased and the heart rate was maintained steadily. (2)Regression of left ventricular hypertrophy was improved. (3)The magnitudes of regression of LVM and LVMI during therapy were greater in the DD group than in the II and ID group. No significant differences of other indices were found in the different genotype groups of ACE. (4)No significant differences of all indices were found in the different genotype groups of CMA. (5)No interaction appeared between the genotypes of the.ACE and the genotypes of the CMA. Conclusion Hypertensive patients with DD genotype were more likely to have regression of left ventricular hypertrophy when treated with ACE inhibitors than patients with other ACE genotypes. No evidence was found to support an association between CMA genotype and regression of LVH in those patients.

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