血管紧张素转换酶基因多态性与糖尿病肾病ACEI疗效的影响

目的探讨血管紧张素Ⅰ转换酶（ＡＣＥ）基因多态性与糖尿病肾病ＡＣＥ抑制剂（ＡＣＥＩ）疗效的相关性。方法随机挑选了３１例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）、５８例ＮＩＤＤＭ合并肾病患者和５０例正常人,用ＰＣＲ方法检测ＡＣＥ基因的缺失／插入的多态性。结果ＮＩＤＤＭ组、ＮＩＤＤＭ合并肾病组和正常人群三组之间,ＡＣＥ基因的几种基因型分布差异无显著意义。对４０例ＮＩＤＤＭ合并肾病患者用ＡＣＥ抑制剂治疗,有效１９例,其中ＤＤ型８例,ＤＩ型２例,Ⅱ型９例;无效２１例,其中ＤＤ型１例,ＤＩ型３例,Ⅱ型１７例（Ｐ＜００１）。结论ＮＩＤＤＭ合并肾病ＡＣＥＩ疗效,ＤＤ型最好,Ⅱ型最差。ＡＣＥＩ基因Ｄ／Ｉ多态性有助于糖尿病肾病ＡＣＥＩ疗效的判定

Association between ACE gene polymorphism and therapeutic responsiveness of ACEI in diabetic nephropathy

OJECTIVE: To clarify the association between ACE gene polymorphism and therapeutic responsiveness of ACEI in diabetic nephropathy. METHOD: With the polymerase chain reaction technique, the angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism was studied in 31 NIDDM patients, 58 NIDDM patients with nephropathy, and 50 normal controls. RESULTS: There was no significant difference in the frequency of ACE genotypes among those NIDDM patients, NIDDM patients with nephropathy and nomal controls. Among 40 patients of DN group treated with ACE inhibitor(ACE-I), there was significant difference in genotype distribution between 19 efficacious cases and 21 nonefficacious cases: 8/2/9 vs 1/3/17 had DD/DI/II genotypes responsively (P < 0.01), DD genotype was best and II genotype was worst in therapeutic efficacy of ACE-I in NIDDM patients with nephropathy. CONCLUTION: The examination of ACE gene polymorphism is helpful for the diagnosis of the therapeutic efficacy of ACE-I in NIDDM with nephropathy.