【摘要】 目的:研究醛固酮合酶基因(CYP11B2)和11-β羟化酶基因(CYP11B1)多态性与醛固酮瘤(Aldosterone-producing adenoma,APA)术后持续性高血压的相关性。方法:对电话随访到的2002～2007年在同济医院就诊的93例APA患者采用Taqman探针法检测DNA多态性,包括CYP11B2基因的rs1799998、rs4539及CYP11B1基因的rs6410和rs6387;采用两对独立的PCR检测CYP11B2基因intron2多态性(野生型/转位型),分析上述位点与预后(血压恢复好/坏)的关系。结果:rs4539与术后高血压相关(P=0.008),校正性别、年龄、身体质量指数后仍相关(P=0.002)。单体型分析表明,整体上CYP11B2-CYP11B1单体型与术后持续性高血压相关(Global sim,P=0.035)。多元回归模型表明,除了传统的风险因素包括术前较长的高血压持续时间、高血压家族史外,单体型H2[OR 1.363(95%CI 1.094～1.689)]、H3[OR 1.555(95%CI 1.148～2.107)]是术后持续性高血压的风险因素,且术前收缩压与单体型H2、H3对术后高血压有协同促进作用(均P<0.005)。结论:APA患者术后血压恢复受到CYP11B2/B1多态性的影响,术前尽早控制血压有助于术后血压的恢复。更多还原

【Abstract】 Objective:To study the association of DNA polymorphisms within CYP11B2 and CYP11B1 gene with continuity hypertension after surgery of aldosterone-producing adenomas(APA).Methods:93 patients with APA who were hospitalized in TongJi hospital during 2002 and 2007 were followed up by telephone interview.All patients were genotyped for rs1799998,rs4539 within CYP11B2 and rs6410,rs6387 within CYP11B1 by Taqman Probes technique.And intron 2 conversion in CYP11B2 was genotyped by two separate PCRs(wild—type / switch-type).Analyzed the relationship between these sites and the prognosis(blood pressure to restore good / bad).Results:Rs4539 was associated with postoperative hypertension in the patients with APA(P = 0.008),and after adjusted by gender,age and body mass index,the association was still significant(P = 0.002).Overall, CYP11B2-CYP11B1 haplotype was associated with postoperative hypertension in the patients with APA(Global sim.P = 0.035) according to haplotype analysis.In linear regression model,two common haplotypes H2[OR 1.363(95%CI 1.094-1.689)],H3[OR 1.555(95%CI 1.148-2.107)]were genetic risk factors of postoperative hypertension after adjusted by the traditional risk factors such as duration of hypertension,family history of hypertension. In addition,interaction between haplotype(H2,H3) and preoperative systolic blood pressure(SBP) was still statistical significant(P<0.005 respectively).Conclusions:These findings suggest postoperative hypertension of patients with APA is influenced by DNA polymorphisms within CYP11B2 and CYP11B1 gene.The preoperative blood pressure control positively influenced postoperative blood pressure.更多还原