血管紧张素转换酶基因多态性与培垛普利对高血压患者内皮舒张功能障碍的干预作用

目的 探讨培垛普利对高血压患者肱动脉内皮舒张功能障碍的干预作用以及血管紧张素转换酶（ACE）基因的插入／缺失（I／D）多态性对这种干预作用的影响。方法 以87名无合并症的老年原发性高血压患者（高血压组）和50名正常老年人（对照组）作为研究对象，用高分辨超声技术检测研究对象的肱动脉内皮舒张功能，用聚合酶链反应（PCR）方法检测研究对象的ACE基因I／D多态性。高血压组在接受培垛普利治疗12周后复测肱动脉内皮舒张功能。结果 高血压组三个基因型亚组的内皮依赖舒张功能与对照组对应的三个基因型亚组比较均有显著减退（P〈0．01）。无论是高血压组还是对照组，具有DD基因型个体的肱动脉内皮依赖舒张功能均显著低于II型个体（P〈0．05）。在高血压组，培垛普利治疗后三个基因型亚组的肱动脉内皮依赖舒张功能与治疗前比较均有显著改善（P〈0．01），改善幅度DD〉ID〉II型，DD型或ID型与II型亚组比较差异有统计学意义（P〈0．01）。结论 培垛普利能逆转老年高血压患者的肱动脉内皮依赖舒张功能障碍，含有D等位基因的患者获益更大。

The relationship between angiotensin converting enzyme gene polymorphism and the improved effect of perindopril on endothelial dysfunction of brachial artery in hypertensive patients

Objective To investigate the role of angiotensin converting enzyme(ACE) gene insertion/deletion(I/D) polymorphism on improved effect of perindopril on endothelial dysfunction of brachial artery in hypertensive patients.Methods Eighty seven elderly essential hypertensive patients without complication of angiopathy(EH group) and fifty healthy subjects(controls group) were selected.The brachial arterial endothelial vasodilatation functions were studied with high-resolution ultrasonography,and the ACE genotypes were determined with polymerase chain reaction(PCR) technique for both groups.In EH group,the brachial arterial endothelial vasodilatation function was measured again after treatment with perindopril for 12 weeks.Results The endothelium-dependent vasodilatation function of three ACE genotype subgroups in hypertensive patients was lower than those of the same genotype subgroup in the control group(P<0.01).In both groups,the subjects with DD genotype had lower endothelium-dependent vasodilatation function than those with II genotype(P<0.05).In EH group,after treatment with perindopril, all of three ACE genotype subgroup got a higher endothelium-dependent vasodilatation function than those before treatment(P<0.01).Among three ACE genotype,the improved degree of endothelium-dependent vasodilatation function in DD or ID genotype was higher than those in II genotype(P<0.01).Conclusion Perindopril has effects on regression of the endothelial dysfunction of brachial artery in elderly hypertensive patients,especially in those with the D allele.