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目的探讨内皮型一氧化氮合酶基因G894T多态性对乐卡地平逆转老年轻中度高血压左心室肥厚(LVH)的影响。方法测定患者的年龄、性别、身高、体重等基线特征,采用基因芯片技术测定eNOS基因型,按GG型,GT+TT基因型分为两组,均给予乐卡地平(10～20 mg/d)治疗,测定治疗前后的血压变化;治疗前后行心脏超声检查,测定相关指标并计算左室重量指数(LVMI)的变化。结果 96例患者中,治疗前GT+TT基因型LVMI高于GG型(F=4.673,P=0.033),多元线性回归示eNOS基因G894T多态性是影响高血压性左心室肥厚的主要因素(Beta=0.218,P=0.033)。治疗后患者收缩压(SBP)、舒张压(DBP)、LVMI均明显下降(t分别为22.680～32.469,P均为0.000),但下降程度GT+TT基因型患者明显大于GG基因型患者(F分别为17.675～35.269,P均为0.000)。结论 eNOS基因G894T多态性可能与轻中度高血压LVH有关;eNOS基因G894T多态性影响乐卡地平逆转老年高血压左心室肥厚。
Objective To investigate the effect of endothelial nitric oxide synthase gene G894T polymorphism on the reversal of left ventricular hypertrophy (LVH) in elderly patients with mild to moderate essential hypertension. Methods The baseline characteristics such as age, sex, height and weight of the patients were determined. Genotypes of eNOS genotypes were determined by genotyping. The genotypes of eNOS were divided into two groups according to GG and GT + TT genotypes. All patients were given lercanidipine (10-20 mg / d ) Treatment, before and after treatment of blood pressure changes; before and after treatment of cardiac ultrasound, determination of relevant indicators and calculate the change of left ventricular mass index (LVMI). Results Among the 96 patients, the LVMI of GT + TT genotype before treatment was higher than that of GG type (F = 4.673, P = 0.033). Multiple linear regression showed that G894T polymorphism of eNOS gene was the main factor affecting hypertensive left ventricular hypertrophy Beta = 0.218, P = 0.033). After treatment, SBP, DBP and LVMI decreased significantly (t = 22.680 ~ 32.469, P = 0.000), but the degree of decline in GT + TT genotype was significantly higher than that in GG genotype Respectively, 17.675 ~ 35.269, P was 0.000). Conclusion The G894T polymorphism of eNOS gene may be related to LVH in mild and moderate hypertension. The eNOS gene G894T polymorphism may affect levodipine in reversing left ventricular hypertrophy in elderly patients with hypertension.