α-内收蛋白基因多态性与氢氯噻嗪降压疗效的相关性研究

目的探讨原发性高血压患者α-内收蛋白基因多态性与氢氯噻嗪降压疗效的相关性。方法829例原发性高血压患者同时服用氢氯噻嗪12．5mg,每日1次,共6周,用PCR—RFLP方法检测α-内收蛋白基因第10外显子G614T单核苷酸多态性（SNP）。资料完整的754例原发性高血压患者按＇IT、GT、GG三种基因型分组,比较不同基因型患者的降压疗效。结果含T等位基因患者的△舒张压（DBP）、A平均动脉压（MAP）值大于GG基因型患者的ADBP、AMAP值,差异有统计学意义（P〈0．05）;TT基因型患者的△收缩压（SBP）、AMAP值大于GT、GG基因型患者的ASBP、AMAP值,差异有统计学意义（P〈0．05）;TT基因型患者的降压有效率高于GT、GG基因型患者的降压有效率,差异有统计学意义（P〈0．05）。多元逐步回归分析显示：TT基因型、治疗前SBP水平是影响收缩压下降值的主要因素。结论α-内收蛋白基因多态性与氢氯噻嗪的降压疗效相关,TT基因型患者的降压疗效最显著。

Association of polymorphism in alpha-adducin gene with antihypertensive effect of Hydrochlorothiazide

OBJECTIVE: To explore the association between G614T single nuclear polymorphism (SNP) of the alpha-adducin gene and the antihypertensive effect of hydrochlorothiazide (HCTZ) in essential hypertensive (EH) patients. METHODS: Eight hundreds twenty nine EH patients were given 12.5 mg HCTZ/d for six weeks. Alpha-adducin gene G614T SNP in the tenth exon was determined by PCR-RFLP in 754 patients with complete records. All the patients were grouped according to TT, GT and GG genotypes. RESULTS: After 6 weeks of HCTZ treatment, the decreases in DBP and MAP of patients carrying 614T allele of alpha-adducin were significantly greater than that of those carrying GG homozygotes (P < 0.05). The decreases in SBP and MAP were significantly greater in patients with the TT genotype as compared with GT or GG genotype (P < 0.05). The effective rate of BP fall by HCTZ was higher in patients with TT genotype than those with GT or GG genotype (P < 0.05). Multivariate stepwise regression analysis showed that the TT genotype and the baseline SBP were the two major predictors affecting the decrease in SBP. CONCLUSION: The present study suggests that the alpha-adducin G614T polymorphism is associated with the antihypertensive effect of HCTZ, which is more effective in patients with TT genotype.