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目的探讨原发性高血压患者血管紧张素转化酶(ACE)I/D基因多态性对血管紧张素转化酶抑制剂(ACEI)类药物治疗的疗效反应。方法应用meta分析有关中国原发性高血压患者进行ACEI类药物治疗与ACE I/D基因多态性相关性的随机对照研究11项。通过综合定量分析,用固定/随机效应模型(D～L法),对DD/DI/II基因型与差值收缩压(dSBP)和差值舒张压(dDBP)进行比较。结果 DD/DI、DD/II和DI/II的收缩压加权均数差及95%可信区间分别为-3.91[-7.28,-0.55]、-6.78[-10.85,-2.70]和-1.21[-2.05,-0.36],P值分别为0.02、0.001和0.005;DD/DI、DD/II和DI/II的舒张压加权均数差及95%可信区间分别为-1.03[-2.32,0.27]、-3.03[-5.17,-0.89]、-1.44[-2.76,-0.12],P值分别为0.12、0.005和0.03。结论 DI基因型、D等位基因的患者对ACEI类降压药物具有更好的疗效反应。
Objective To investigate the response of angiotensin-converting enzyme (ACE) I / D gene polymorphism to angiotensin-converting enzyme inhibitor (ACEI) therapy in patients with essential hypertension. Methods A meta-analysis of 11 randomized controlled trials on the association of ACE inhibitors with ACE I / D gene polymorphisms in patients with essential hypertension in China. DD / DI / II genotypes were compared with differential systolic blood pressure (dSBP) and differential diastolic blood pressure (dDBP) by comprehensive quantitative analysis using the fixed / random effects model (D-L method). Results The weighted mean difference in 95% confidence intervals for DD / DI, DD / II and DI / II were -3.91 [-7.28, -0.55], -6.78 [-10.85, -2.70] and -1.21 [ -2.05, -0.36] respectively, with P values of 0.02, 0.001 and 0.005, respectively; and the weighted mean difference in the diastolic blood pressure and the 95% confidence intervals for DD / DI, DD / II and DI / II were -1.03 [-2.32 and 0.27 ], -3.03 [-5.17, -0.89], -1.44 [-2.76, -0.12], P values were 0.12, 0.005 and 0.03, respectively. Conclusion Patients with DI genotype and D allele have better response to ACEI antihypertensive drugs.