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目的探讨醛固酮合酶(CYP11B2)基因-344C/T多态性预测原发性高血压(EH)合并早期肾损伤的价值。方法根据尿微量白蛋白/尿肌酐比值(UACR),394例EH患者分成高血压合并早期肾损伤(RD组,30mg/g≤UACR<300mg/g,154例)和高血压未合并早期肾损伤(NRD组,UACR<30mg/g,240例);40例健康志愿者作为对照组。比较各组相关临床指标、CYP11B2基因-344C/T基因型和等位基因频率,并分析EH合并早期肾损伤的影响因素。结果 RD组CC基因型频率低于NRD组,TT基因型和T等位基因频率高于NRD组(P<0.05);三组基因型和等位基因频率无统计学差异(P>0.05)。CT型和CC型患者SBP、DBP和血浆醛固酮(ALD)水平低于TT型(P<0.05),CC型患者ALD水平低于CT型(P<0.05)。Logistic回归分析显示,UACR与CYP11B2基因-344C/T基因型、SBP有关(P<0.05)。结论 EH患者合并早期肾损伤与CYP11B2基因-344C/T多态性有关,携带T等位基因的EH患者更容易产生早期肾损伤;基因检测可预示EH患者早期肾损伤。
Objective To investigate the value of -344C / T polymorphism of aldosterone synthase (CYP11B2) gene in predicting essential hypertension (EH) combined with early renal injury. Methods According to the urinary albumin / urinary creatinine ratio (UACR), 394 EH patients were divided into hypertension with early renal injury (RD group, 30mg / g≤UACR <300mg / g, 154 cases) and hypertension without early renal injury (NRD group, UACR <30mg / g, 240 cases); 40 healthy volunteers served as the control group. The relative clinical indexes, CYP11B2 gene -344C / T genotypes and allele frequencies were compared between groups, and the influencing factors of EH combined with early renal injury were analyzed. Results The frequencies of CC genotypes in RD group were lower than those in NRD group. The frequencies of TT genotype and T allele were higher in NR group than those in NRD group (P <0.05). There was no significant difference in genotype and allele frequency between RD group and control group (P> 0.05). The levels of SBP, DBP and plasma aldosterone (ALD) in patients with CT and CC were lower than those with TT (P <0.05), while those with CC were lower than those with CT (P <0.05). Logistic regression analysis showed that UACR was associated with CYP11B2 gene -344C / T genotype and SBP (P <0.05). Conclusion EH patients with early renal injury and CYP11B2 gene -344C / T polymorphism in patients with EH T allele is more likely to have early renal damage; genetic testing can predict EH patients with early renal injury.