南阳地区高血压人群基因多态性与抗高血压药物个体差异性关系临床研究

目的：分析河南省南阳地区抗高血压药物相关基因分布特征，为该地区高血压患者个体化治疗提供参考，提高抗高血压治疗的经济效益。方法原发性高血压患者135例，通过Tap-man探针法对目前国内外已达成共识的五大类降压药疗效相关的13个基因位点进行检测，分析相关基因在不同人群的分布特征。结果（1）南阳地区高血压患者可能对氢氯噻嗪、氨氯地平、氯沙坦类药物疗效较好；（2）美托洛尔降压效果一般且发生心动过缓风险过高；（3）女性患者服用ACEI类药物后咳嗽风险明显高于男性，且效果较男性差（P＜0.05）；（4）肥胖高血压患者可能对氨氯地平效果较好（P＜0.05）。结论南阳地区的高血压患者可广泛应用氢氯噻嗪、氨氯地平、氯沙坦类药物；对美托洛尔效果可能较差，不建议广泛应用；女性患者不建议应用ACEI类药物；肥胖患者应用氨氯地平效果可能较好。

Clinical study on the relationship between the gene polymorphism and individual differences of antihypertensive drugs of hypertensive population in Nanyang area

Objective To analyze the related gene distribution of antihypertensive drugs in Nanyang area of Henan province, in order to provide the reference for the individual treatment of hypertensive patients in this area, and improve the economic benefits of antihypertensive treatment. Methods 13 gene locus which were related to the efficacy of five classes of antihypertensive drugs and accepted by the domestic and foreign professional in 135 patients with essential hypertension were tested by Tap-man probe method, and the related gene distribution in different population were analysed. Results （1）The efficacy of hydrochlorothiazide, amlodipine and losartan might be better for the hypertension patients in Nanyang area; （2）Metoprolol had the poor antihypertensive effect and high risk of bradycardia;（3）The risk of cough in the female patients who took ACEI drugs was significantly higher than that in the male patients, and the effect of the female patients who took ACEI drugs was worse（P 〈 0.05）;（4）Amlodipine might have a better effect for the hypertension patients with obesity（P 〈 0.05）. Conclusion The patients with hypertension in Nanyang area can widely use the hydrochlorothiazide, amlodipine and losartan, but metoprolol is just the opposite, and not recommended for wide application.The female patients does not be suggested the application of ACEI.The obesity patients may have better effect on amlodipine.