α-adducin基因多态性与年龄、性别、体质指数对氢氯噻嗪降压敏感性的相关性研究

目的 研究α-adduein基因G614T多态性和性别、年龄、体质指数与氢氯噻嗪降压敏感性的相关性.方法 829例原发性高血压患者同时服用氢氯噻嗪12.5 mg,1次/d,6周末资料完整的754例患者按不同α-adducin基因型分组,比较不同基因型患者收缩压和舒张压的下降值,并进一步分层分析不同性别、年龄、体质指数的患者对氢氯噻嗪的降压敏感性与基因型的关系.结果 服用氢氯噻嗪6周末,竹基因型患者收缩压水平最低,且血压下降最明显,与GT、GG基因型比较差异均有统计学意义(均P＜0.05);虽然GT、TT基因型患者舒张压下降值明显大于GG基因型患者,差异有统计学意义(P＜0.05),但治疗后3种基因型患者的平均舒张压水平差异无统计学意义(P＞0.05);男性、年龄＜60岁、体质指数＜28的不同基因型患者间,血压下降差异均有统计学意义(均P＜0.05);多元逐步回归分析表明,在多因素水平TT基因型仍与氢氯噻嗪障低收缩压的敏感性相关.结论 ①TT基因型原发性高血压患者对氢氯噻嗪的降压敏感性较高.②TT基因型原发性高血压患者的收缩压对氢氯噻嗪的敏感性高于舒张压对氢氯噻嗪的敏感性.③男性、年龄＜60岁、体质指数＜28的原发性高血压患者,对氢氯噻嗪降压作用的敏感性较高.

Study on the correlation of polymorphism of α-adducine gene and sensitivity of age, sex and body mass index to hydrochlorothiazide

Objective To explore the correlation of polymorphism of α-adducine gene and sensitivity of age, sex and body mass index(BMI)to hydrochlorothiazide(HCTZ). Methods Eight hundreds twenty nine essential hypertensive(EH)patients were given 12. 5 mg HCTZ/d for six weeks. Α-adducine gene G614T SNP in the tenth exon was determined by PCR-RFLP in 754 patients with complete records. All the patients were divided according to TT, GT and GG genotypes. The decreases of SBP and DBP after treatment across α-adducin genotypes and age, sex, BMl were compared. Results The decrease in SBP of patients carrying TT of α-adducin gene was significantly greater than that of those with GT or GG(P＜0.05), but not the DBP(P＞0.05). The sensitivity of decreased SBP Was significantly different among α-adducin genotypes in males, patients under 60 years old and those whose BMI were were less than 28(P＜0.05). Multipvariate stepwise regression analysis showed that the TT genotype was associated with the sensitivity to HCTZ. Conclusion ①The patients with TT genotype have the highest sensitivity to the effect of HCTZ. ②In terms of the sensitivity to HCTZ, the effect of TT genotype to SBP is greater than to DBP. ③Male patients, patients under 60 years old and those whose BMI less than 28 have the antihypertensive response of α-adducin genotype to HCTZ.