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目的探讨高血压病患者ACE基因I/D多态性与卡托普利咳嗽副反应、ACE水平的关系。方法筛选高血压病患者,检测ACE基因I/D多态性,按ACEI/D基因型分为II型、ID型和DD型三组,给予卡托普利降压治疗8周,随访观察患者咳嗽副反应发生情况,紫外法检测治疗前后ACE水平。比较三组间上述指标的差异,并分析其间的可能关系。结果ACEII组咳嗽副反应发生率(57.1%),显著高于ID组(P<0.05)、DD组(P<0.05);ID组咳嗽副反应发生率较DD组为高,但差异无统计学意义(P>0.05)。三组间治疗前、治疗后ACE水平差异有显著统计学意义(P均<0.001);治疗前DD组显著高于ID组(P<0.001)、II组(P<0.001),ID组显著高于II组(P<0.001);治疗后结果相同(P均<0.001)。结论携带ACEII基因型的高血压病患者服用卡托普利,咳嗽副反应的发生率高于其它两型患者,ACE水平低于其他两型患者,ACE水平较低是高血压病患者出现ACEI相关性咳嗽的重要原因。
Objective To investigate the relationship between ACE gene I / D polymorphism and the adverse reaction of captopril and ACE in hypertensive patients. Methods The ACE gene I / D polymorphism was detected in patients with hypertension. The ACEI / D genotypes were divided into three groups according to ACEI / D genotypes: type II, type ID and type DD. Patients were given captopril for 8 weeks. Cough side effects occurred, UV detection of ACE levels before and after treatment. The differences between the above three indicators were compared and the possible relationship between them was analyzed. Results The incidence of cough in ACEII group (57.1%) was significantly higher than that in ID group (P <0.05) and DD group (P <0.05). The incidence of cough in ID group was higher than that in DD group Significance (P> 0.05). There were significant differences in ACE levels between the three groups before and after treatment (P <0.001). Before treatment, the levels of ACE in ID group were significantly higher than those in ID group (P <0.001), II group (P <0.001) In group II (P <0.001), the results were the same after treatment (all P <0.001). Conclusions Captopril is taken in hypertensive patients with ACEII genotype. The incidence of cough and side reaction is higher than that of the other two types of patients, and the level of ACE is lower than that of the other two types of patients. The low level of ACE is associated with ACEI in hypertensive patients An important reason for coughing.