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按照血管紧张素转换酶 (ACE)基因插入 /缺失多态性不同 ,将 92例 2型糖尿病肾病患者分为II型组 31例 ,ID型组 30例及DD型组 31例。用苯那普利治疗 6个月后 ,观察治疗前后各组的尿白蛋白排泄率 (UAER)、平均动脉压 (MABP)、肌酐清除率 (Ccr)及ACE的变化。结果 :苯那普利治疗后 3组UAER、MABP、ACE均下降 ,以II型组下降幅度最大 (分别为 58.6%、2 .87kPa和 72 .3% ) ,DD型组下降幅度最小 (P <0 .0 5) ;而Ccr在DD型组下降幅度最大 ,II型组下降幅度最小 (P <0 .0 5) ;多元线性逐步回归分析显示 :ACE基因型对UAER下降率有显著回归效果(R2 =0 .72 ,P <0 .0 0 1 )。提示 :ACE基因型影响血管紧张素转换酶抑制剂 (ACEI)对糖尿病肾病的疗效 ,II基因型患者对ACEI治疗更为敏感。
92 patients with type 2 diabetic nephropathy were divided into type II group (n = 31), ID type group (n = 30) and DD type group (n = 31) according to the gene insertion / deletion polymorphism of angiotensin converting enzyme (ACE) After being treated with benazepril for 6 months, the urinary albumin excretion rate (UAER), mean arterial pressure (MABP), creatinine clearance (Ccr) and ACE in each group were observed before and after treatment. Results: After benazepril treatment, the levels of UAER, MABP and ACE in the three groups were decreased, and in the type II group, the decline was the largest (58.6%, 2.87 kPa and 72.3%, respectively) 0.05). Ccr decreased the most in type DD group and the lowest in type II group (P <0.05). Multiple linear stepwise regression analysis showed that ACE genotype had a significant regression effect on the rate of UAER decline (P < R2 = 0.72, P <0. 001). Tip: ACE genotypes affect the efficacy of angiotensin converting enzyme inhibitor (ACEI) on diabetic nephropathy, and patients with genotype II are more sensitive to ACEI treatment.