摘要目的 探讨α-内收蛋白(α-adducin)基因G460T和血管紧张素转换酶(angiotensin converting enzyme,AcE)基因插入或缺失(insertion/detetion,I/D)多态性与汉族盐敏感性高血压(salt-sensitive hypertension,SSHT)及早期肾损害的关系.方法 用改良的Sullivan's法(急性口服盐水负荷试验)将200例原发性高血压(essential hypertension,EH)患者分为盐敏感109例和非盐敏感91例,用PCR检测ACE基因I/D多态性基因型,聚合酶链反应-限制性片段长度多态性方法检测α-adducin基因型,用放射免疫法检测晨尿微量白蛋白.结果 (1)EH组的α-adducin基因TT型频率显著高于健康对照组(200名)(P＜0.05),而EH组和对照组ACE I/D基因型分布差异无统计学意义(P＞0.05);盐敏感组的α-adducin基因TT型、α-adducin基因TT+ACE Ⅱ型频率显著高于非盐敏感组(P＜0.05).(2)盐敏感组尿微量白蛋白/尿肌酐显著高于非盐敏感组(P＜0.05);盐敏感组的ACE Ⅱ型尿微量白蛋白/尿肌酐显著高于ID、DD型(P＜0.05),α-adducin基因TT型尿微量白蛋白/尿肌酐显著高于GT、GG型(P＜0.05),α-adduein基因TT+ACE基因Ⅱ型尿微量自蛋白/尿肌酐显著高于其它基因组合型(P＜0.05).结论 α-adducin基因TT基因型或与ACE基因Ⅱ型协同可能是SSHT的遗传标志之一,可能是SSHT早期肾损害的遗传易感因素.

abstractsObjective To investigate the association between the α-adducin gene G460T,angiotensin converting enzyme(ACE)insertion/deletion(I/D)polymorphisms and salt-sensitive hypertension and early renal injury in Chinese people.Methods The case-control study was performed in 200 essential hypertension(EH)and 200 normal control subjects in China.The 200 EH patients were divided into salt-sensitive(SS=109)and non-salt-sensitive(NSS=91)groups according to modified Sullivan's method.The genotypes of α-adducin gene were determined by polymerase chain reaction-restriction fragment length pelymorphism(PCR-RFLP).The ACE genotypes were determined by PCR.The urine microalbum(Alb)in 200 EH subjects was measured by radioactive immunoassay.Results (1)A higher frequency of α-adducin gene G460T TT in EH patients was observed(P＜0.05).No significant difference of the ACE gene I/D polymorphism was found between the EH patients and normal control(P＞0.05).There were significant differences in the α-adducin gene TT genotype and combined genotype of TT+Ⅱ between SS and NSS subjects(P＜0.05).(2)The levels of urine Alb/Cr in SS patients were significantly higher than that in NSS patients(P＜0.05);in SS group,the levels of urine Alb/Cr in ACE Ⅱ and α-adducin gene TT genotypes were higher than that in ACE ID,DD genotype and α-adducin gene GT and GG genotypes.The levels of urine Alb/Cr in the group of α-adducin gene TT+ACE Ⅱ combined genotype were higher than that in other combined genotypes(P＜0.05).Conclusion The α-adducin gene TT genotype or combined with ACE Ⅱ are significantly associated with SS hypertension.The α-adducin gene TT and ACE Ⅱ genotypes might be genetic susceptibility factors to hypertension accompanying renal injury.