摘要
目的分析细胞色素P450酶2C9*3(CYP2C9*3)和血管紧张素Ⅱ1型受体(AGTR1)(1166A>C)基因多态性是否与原发性高血压(EH)患病风险和厄贝沙坦临床降压疗效相关。方法选择2018年1月至2019年7月在徐州医科大学附属医院就诊的EH患者2057例和健康对照者286人,采用基因芯片法进行基因型鉴定,其中598例EH患者口服厄贝沙坦150mg/d,持续4周。收集受试者服药前和服药第4周末的收缩压、舒张压,计算服药前后的血压降低幅度。结果EH组与对照组的CYP2C9*3和AGTR1(1166A>C)两种基因分布差异无统计学意义(均P>0.05)。对于CYP2C9*3基因型,与*1*1组相比,*1*3+*3*3组的收缩压降低值和舒张压降低值更大[分别为(34.9±15.5)比(29.3±10.2)mm Hg和(22.8±9.0)比(19.6±8.5)mm Hg];对于AGTR1(1166A>C)基因型,与AA组相比,AC+CC组具有更好的降压疗效[收缩压降低值(32.1±14.2)比(29.2±13.4)mm Hg,舒张压降低值(21.2±9.4)比(19.4±8.4)mm Hg],但两者差异无统计学意义(均P>0.05)。通过协方差分析发现,在男性亚组中与AA组相比,AC+CC组收缩压降低值和舒张压降低值更大[分别为(31.9±1.7)比(28.0±0.6)mm Hg和(22.1±1.1)比(19.0±0.4)mm Hg],且差异有统计学意义(分别P=0.04和0.01)。结论CYP2C9*3和AGTR1(1166A>C)基因型在淮海地区汉族EH与非EH人群中的分布无差异,AGTR1(1166A>C)基因型对男性的厄贝沙坦降压疗效具有影响,AC+CC组比AA组的降压疗效更好。
Objective To analyze whether the cytochrome P450 enzyme 2 C9*3(CYP2 C9*3)and angiotensinⅡreceptor 1(AGTR1)(1166 A>C)gene polymorphisms are associated with the risk of essential hypertension(EH)and the clinical antihypertensive effect of irbesartan.Methods A total of 2057 EH patients and 286 healthy controls in the Affiliated Hospital of Xuzhou Medical University from January 2018 to July 2019 were selected for genotyping by gene chip method.A total of 598 patients with EH were given irbesartan 150 mg/d for 4 weeks.The systolic and diastolic blood pressures of the subjects were collected before and at the end of 4 th week of the medication,and the blood pressure reduction values before and after the medication were calculated.Results There was no significant difference in the distribution of CYP2 C9*3 and AGTR1(1166 A>C)between the EH group and the control group(both P>0.05).For the CYP2 C9*3 gene,compared with the*1*1 group,the*1*3+*3*3 group had higher systolic blood pressure and diastolic blood pressure reduction values[(34.9±15.5)vs(29.3±10.2)mm Hg and(22.8±9.0)vs(19.6±8.5)mm Hg,respectively];for the AGTR1(1166 A>C)gene,compared with the AA group,the AC+CC group had a higher antihypertensive effect[systolic blood pressure reduction(32.1±14.2)vs(29.2±13.4)mm Hg,diastolic blood pressure reduction(21.2±9.4)vs(19.4±8.4)mm Hg],but the difference was not statistically significant(both P>0.05).However,analysis of covariance-corrected covariates found that the AC+CC group had higher systolic blood pressure and diastolic blood pressure reduction values in the male subgroup[(31.9±1.7)vs(28.0±0.6)mm Hg and(22.1±1.1)vs(19.0±0.4)mm Hg,respectively],and both reached statistical significance(P=0.04 and 0.01,respectively).Conclusion There is no statistical difference between CYP2 C9*3 and AGTR1(1166 A>C)in EH and non-EH Han population in Huaihai area,the genotype of AGTR1(1166 A>C)has an effect on the antihypertensive effect of irbesartan in males,the antihypertensive effect of AC+CC group is better than that of AA group.
作者
董辉
王凤珍
拾坤
张学善
吕冬梅
DONG Hui;WANG Feng-zhen;SHI Kun;ZHANG Xue-shan;LüDong-mei(Department of Clinical Pharmacy,First Clinical College of Xuzhou Medical University,Xuzhou Jiangsu 221009,China;不详)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2020年第6期532-538,共7页
Chinese Journal of Hypertension
基金
国家自然科学基金青年基金项目(81803473)
徐州市应用基础研究计划(KC-18041:KC-19069)
江苏省药学会基金项目(Q2018051)
北京公益基金项目(YWJKJJHKYJJ-A720)。
