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目的研究原发性高血压(EH)患者的血管紧张素原(AGT)基因M235T多态性与贝那普利降压疗效的相关性。方法251例EH患者口服贝那普利10～20mg/d,进行为期6周的降压治疗。用聚合酶链反应(PCR)和限制性酶切方法检测所有患者的AGT基因M235T多态性,按MM、MT和TT三种基因型分组。治疗前后及治疗过程中对患者的收缩压(SBP)和舒张压(DBP)等进行监测,以比较不同基因型患者之间的降压疗效。结果基因型为MM、MT及TT者分别为23例(9.2%)、104例(41.4%)和124例(49.4%);在251例患者中,MM、MT及TT三组患者间治疗后SBP和DBP的降幅差异无统计学意义(P>0.05);按年龄分层进行的亚组分析显示:在≥60岁的老年亚组中,治疗后MM、MT及TT三组患者DBP的降幅分别为(14.8±4.8)mmHg,(7.9±7.7)mmHg和(9.8±6.4)mmHg(P=0.034),MM较MT和TT组的DBP降幅大。结论本研究显示,老年(≥60岁)EH患者的AGTM235T多态性与贝那普利降压疗效相关,提示特定的基因多态性可能会影响某些降压药物的疗效。
Objective To investigate the association between the M235T polymorphism of angiotensinogen (AGT) gene and the antihypertensive efficacy of benazepril in patients with essential hypertension (EH). Methods 251 patients with EH were treated with benazepril 10 ~ 20mg / d for 6 weeks. The AGT gene M235T polymorphism in all patients was detected by polymerase chain reaction (PCR) and restriction enzyme digestion, and classified according to MM, MT and TT genotypes. Patients were monitored for systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after treatment and during treatment to compare antihypertensive effects among different genotypes. Results The genotypes of MM, MT and TT were 23 cases (9.2%), 104 cases (41.4%) and 124 cases (49.4%), respectively. Among the 251 patients, MM, MT and TT There was no significant difference in the decrease of SBP and DBP (P> 0.05). Sub-group analysis by age stratification showed that in the elderly subgroup of 60 years or older, the decrease of DBP in MM, MT and TT patients after treatment (14.8 ± 4.8) mmHg, (7.9 ± 7.7) mmHg and (9.8 ± 6.4) mmHg respectively (P = 0.034). The decline of DBP in MM group was larger than that in MT group and TT group. CONCLUSIONS: This study shows that AGTM235T polymorphism in elderly patients (≥60 years) with EH is associated with benazepril’s antihypertensive effect, suggesting that specific genetic polymorphisms may influence the efficacy of some antihypertensive drugs.