论文部分内容阅读
目的:探讨性别差异对不同血管紧张素转换酶(ACE)基因型高血压患者服用氢氯噻嗪后血清肾素-血管紧张素-醛固酮系统(RAAS)活性变化的影响。方法:根据自愿原则,随机纳入829例轻、中度高血压患者。所有患者均停服原有的抗高血压药物,并经过2周的安慰剂清洗期,随后口服氢氯噻嗪12.5mg,qd,连续服药6周。分析不同性别、ACE基因型患者服用氢氯噻嗪后血清RAAS水平的变化及二者之间的交互作用。结果:共776例研究对象完成了研究并纳入分析。DD基因型男性患者服用氢氯噻嗪6周后血清ACE和血管紧张素Ⅱ(AngⅡ)水平升高幅度均高于II、ID基因型男性患者(P<0.05);而在女性中,DD基因型患者血清ACE和AngⅡ水平升高幅度却明显低于II、ID基因型女性患者(P<0.05)。性别与ACE基因插入/缺失(I/D)多态性对服用氢氯噻嗪后血清ACE水平变化存在明显交互作用(P=0.032),对血清AngⅡ水平变化存在临界交互作用(P=0.070)。结论:校正年龄、体重指数和基线血压水平后,性别与ACE基因I/D多态性对服用氢氯噻嗪后血清ACE水平变化存在明显交互作用。
Objective: To investigate the effect of gender differences on the changes of serum renin - angiotensin - aldosterone system (RAAS) activity after taking hydrochlorothiazide in patients with different angiotensin converting enzyme (ACE) genotypes. Methods: According to the voluntary principle, 829 patients with mild to moderate hypertension were enrolled. All patients were stopped taking the original antihypertensive drugs, and after 2 weeks of placebo cleansing period, followed by oral hydrochlorothiazide 12.5mg, qd, continuous medication for 6 weeks. To analyze the changes of serum RAAS levels and the interaction between them after taking hydrochlorothiazide in different genders and ACE genotypes. Results: A total of 776 subjects completed the study and were included in the analysis. The levels of serum ACE and angiotensin Ⅱ in DD genotype male patients after 6-week treatment were higher than those in II and ID genotypes (P <0.05), but in women, DD genotype serum The increase of ACE and AngⅡ level was significantly lower than that of female genotype II and ID (P <0.05). Sex and ACE gene insertion / deletion (I / D) polymorphisms had a significant interaction (P = 0.032) on serum ACE levels after hydrochlorothiazide administration, with a significant interaction (P = 0.070) on serum AngⅡ levels. CONCLUSIONS: After adjusting for age, body mass index and baseline blood pressure levels, gender and ACE gene I / D polymorphisms have a significant interaction with serum ACE levels after hydrochlorothiazide administration.