【作者】 文育锋；

【导师】 徐希平； 臧桐华； 王滨燕； 唐根富；

【作者基本信息】 安徽医科大学 ， 流行病与卫生统计学， 2005， 硕士

【摘要】 目的: 分别探讨低密度脂蛋白受体相关蛋白8(LRP8)和神经肽Y2受体基因多态性对苯那普利降压疗效的影响。 方法: 选取中国安徽某两地区原发性高血压患者,服用苯那普利,每日10mg,追踪观察15天。测量服药前后血压值,调查人口学特征、测定其基因型并了解其分布特点,从其中选取降压疗效最好和最差的研究对象422人,研究苯那普利的降压疗效和LRP8及NPY2R基因的多态性的关系。 结果: 一LRP8基因多态性和苯那普利降压疗效的关系:(1) 研究人群在LRP8基因的不同基因型间年龄、体重、体质指数、基线收缩压、舒张压下降值、当前是否吸烟、饮酒等因素差异均无显著性;(2) HWE平衡检验未发现三种基因型的频率有显著性差异(x~2=3.45,p=0.063);(3) LRP8的基因突变后影响苯那普利的降压疗效,①在BMI<24kg/m~2的原发性高血压人群中LRP8的基因的突变组(AC)能使收缩压比野生型(AA)的人群下降5.68mmHg(校正前β±SE:5.52±2.89mmHg,p=0.0562,校正后β±SE:5.68±2.52mmHg,p=0.0403);②在轻度原发性高血压人群中(159=>SBP>=140mmHg or 99=>DBP>=90mmHg),LRP8的基因突变组(AC)能使收缩压和舒张压比野生型(AA)的人群分别下降6.14mmHg和3.81mmHg(收缩压校正前β±SE:6.22+2.71mmHg,p=0.0215,校正后β±SE:6.14±2.58mmHg,p=0.0172;舒张压校正前β±SE:3.69+1.95mmHg,p=0.0588,校正后β±SE:3.81±1.84mmHg,p=0.0387)。 二NPY2R基因多态性和苯那普利降压疗效的关系:(1) 研究人群在不同基因型间体重、腰围、腰臀比差异有显著性(p值分别为0.0322、0.0099和0.0108),更多还原

【Abstract】 Aim To ascertain whether the low density lipoprotein receptor-related protein 8(LRP8) and the neuropeptide Y receptor 2 (NPY2r) polymorphisms are associated with the afficacy of treatment of essential hypertensive patients with Benazepril. Methods We conducted essential hypertensive subjects from two Counties of Anhui, China, respectively. Both systolic and diastolic blood pressures (SBP and DBP) before and after 15-day benazepril treatment were measured. LRP8 genotypes were determined for all subjects. We selected 422 objects of SBP or DBP decrease and increase extremely value to detemined the LRP8 and NPY2R genotype and analyse the association between the gene polymorphism and afficacy of the Benazepril treatment. Results 1. LPR8 Polymorphism and Systolic and Diastolic Blood Pressure Decreases After 15 days of Benazepril Treatment. (1 )The age, weight, the body mass index, the baseline of systolic blood pressure and the diastolic blood pressure are not differ with two subpopulation. (2) The frequency of LRP8 genotypes are equal and no significant different with Hard-weiberg equivalent tests. (3) The LRP8 polymorphism was associated with SBP decrease in response to the 15-day benazepril treatment in subpopulation with BMK24kg/m2 (Crude: β±S: 5.00±2.63mmHg, P = 0.0573;Adjusted: β±SE: 5.18±2.52mmHg), p=0.0395).However, there was no associated with SBP decrease and DBP decrease in response to 15-day benazepril treatment in subpopulation with BMI>=24kg/m2. And we also found that the LRP8 polymorphism was associated with SBP and DBP decrease in response to the 15-day benazepril treatment in subpopulation with mild BP subpopulation (159=>SBP>=140mmHg or 99=>DBP>=90mmHg) (SBP decrease, Crude: p±SE:5.99±2.49mmHg, p=0.0162; Adjusted: β±SE: 5.98±2.41mmHg , p=0.0162; DBP decrease, Crude:更多还原