CAJ | 학술논문

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.
목적 연구α-adduein기인G614T다태성화성별、년령、체질지수여경록새진강압민감성적상관성.방법 829례원발성고혈압환자동시복용경록새진12.5 mg,1차/d,6주말자료완정적754례환자안불동α-adducin기인형분조,비교불동기인형환자수축압화서장압적하강치,병진일보분층분석불동성별、년령、체질지수적환자대경록새진적강압민감성여기인형적관계.결과 복용경록새진6주말,죽기인형환자수축압수평최저,차혈압하강최명현,여GT、GG기인형비교차이균유통계학의의(균P＜0.05);수연GT、TT기인형환자서장압하강치명현대우GG기인형환자,차이유통계학의의(P＜0.05),단치료후3충기인형환자적평균서장압수평차이무통계학의의(P＞0.05);남성、년령＜60세、체질지수＜28적불동기인형환자간,혈압하강차이균유통계학의의(균P＜0.05);다원축보회귀분석표명,재다인소수평TT기인형잉여경록새진장저수축압적민감성상관.결론 ①TT기인형원발성고혈압환자대경록새진적강압민감성교고.②TT기인형원발성고혈압환자적수축압대경록새진적민감성고우서장압대경록새진적민감성.③남성、년령＜60세、체질지수＜28적원발성고혈압환자,대경록새진강압작용적민감성교고.
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.