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目的研究原发性高血压(EH)患者血管紧张素转换酶(ACE)基因I/D、醛固酮合酶(CYP11B2)基因344T/C和α内收蛋白(αadducin)基因G614T不同基因多态性组合与氢氯噻嗪(HCTZ)降压疗效的关系。方法829例EH患者同时服用HCTZ12.5mg,1次/d,共6周。资料完整的716例患者按ACE、CYP11B2及αadducin不同基因多态性组合,比较不同基因多态性组合患者的降压疗效。结果27种不同多态性组合中,ACEID+CYPTT+αadducinTG多态性组合在患者中分布频率最高(ACEDD+CYPTC+αadducinTT)基因多态性组合的患者收缩压下降值最大(17.7±30.5)mmHg,显著高于其它基因多态性组合(P<0.05);多元逐步回归分析提示:ACE基因DD型、αadducin基因TT型、ACEDD+CYP11B2TC+αadducinTT基因多态性组合等是影响患者收缩压下降值的主要因素。结论不同ACE基因I/D、CYP11B2基因344T/C、αadducin基因G614T多态性组合患者对氢氯噻嗪的降压疗效存在差异;ACEDD+CYP11B2TC+αadducinTT基因多态性组合对HCTZ的降压疗效优于其他基因多态性组合的患者。
Objective To investigate the association of angiotensin converting enzyme (ACE) gene I / D, aldosterone synthase (CYP11B2) gene 344T / C and αadducin gene G614T polymorphism in patients with essential hypertension (EH) And hydrochlorothiazide (HCTZ) antihypertensive efficacy of the relationship. Methods 829 patients with EH simultaneously taking HCTZ12.5mg, 1 time / d, a total of 6 weeks. The 716 patients with complete data were grouped according to the polymorphism of ACE, CYP11B2 and αadducin to compare the antihypertensive effect of different gene polymorphism patients. Results Among the 27 polymorphic combinations, the systolic blood pressure decreased with the combination of ACEID + CYPTT + αadducinTG polymorphism in patients with the highest frequency of ACEDD + CYPTC + αadducinTT (17.7 ± 30.5) mmHg (P <0.05). Multiple stepwise regression analysis indicated that ACE gene DD type, αadducin gene TT type and ACEDD + CYP11B2TC + αadducinTT gene polymorphism were associated with decreased systolic blood pressure The main factor. Conclusions The hypotensive effect of hydrochlorothiazide is different in patients with different ACE gene I / D and CYP11B2 gene 344T / C and αadducin gene G614T polymorphism. The antihypertensive effect of ACEDD + CYP11B2TC + αadducinTT gene polymorphism is better than other Patients with a combination of genetic polymorphisms.