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基因检测指导下的个体化用药在农村高血压患者管理中的效果评价
引用本文:倪小丽,汤权琪,邹仕贵,李伦兰,张胜权.基因检测指导下的个体化用药在农村高血压患者管理中的效果评价[J].中华疾病控制杂志,2019,23(10):1284-1288.
作者姓名:倪小丽  汤权琪  邹仕贵  李伦兰  张胜权
作者单位:230000 合肥,安徽医科大学第一附属医院护理部;231500 合肥,庐江县人民医院心内科;231500 合肥,庐江县人民医院肿瘤科;231500 合肥,庐江县人民医院护理部;230000 合肥,安徽医科大学第一附属医院护理部;230000 合肥,安徽医科大学基础医学院教研室
基金项目:安徽省高校自然科学研究项目KJ2017A195
摘    要:  目的  研究基因检测指导用药与家庭医生相结合的管理模式在农村原发性高血压患者中的应用成效。  方法  将安徽农村209例原发性高血压患者分为试验组(105人)和对照组(104人)。在家庭医生签约模式下,对试验组结合个体化用药基因检测结果指导用药,对照组实施常规用药。经6个月干预,观察两组患者的治疗依从性、药物不良反应率、血压值和体重指数(body mass index,BMI)、空腹血糖(fasting blood glucose,FBG)、血清总胆固醇(total cholesterol,TC)和甘油三酯(triglycerides,TG)的变化。  结果  干预6个月后,试验组患者的服药依从性明显高于对照组,血压值和药物不良反应率明显低于对照组;干预3个月后,两组患者的BMI、FBG、TC和TG均无明显下降,干预6个月后,试验组FBG、TC和TG均有明显下降,对照组仅FBG值有明显下降,两组患者的BMI值均无明显变化。  结论  家庭医生签约服务模式下,基因检测指导用药能提高原发性高血压患者的服药依从性,降低药物不良反应率,提高治疗效率。

关 键 词:基因检测  家庭医生签约服务  农村地区  原发性高血压
收稿时间:2019-06-17

Evaluation of individualized medication under the guidance of genetic testing in the management of hypertension patients in rural areas
Affiliation:1.Nursing Department, Anhui First Affiliated Hospital of Anhui Medical University, Hefei 230000, China2.Department of Cardiology, People's Hospital of Lujiang County, Anhui Medical University, Hefei 231500, China3.Department of Oncology, People's Hospital of Lujiang County, Hefei 231500, China4.Nursing Department, People's Hospital of Lujiang County, Hefei 231500, China5.Department of Basic Medical Sciences, Anhui Medical University, Hefei 230000, China
Abstract:  Objective  This study combined genotyping with family doctors' contracting model to assess the application of precision medicine in rural patients with essential hypertension.  Methods  In this study, 209 hypertensive patients from 3 villages in Lujiang County, Hefei City, Anhui Province were selected as subjects and randomly divided into experimental group(n=105) and control group(n=104). The medication regimen of observation group was guided by genetic testing for gene sensitivity to antihypertensive drugs, and the control group was implemented routine pharmacy. All the patients were managed by family doctors. Adverse drug reaction rate, treatment compliance, blood pressure, body mass index (BMI), fasting blood glucose (FBG), cholesterol (TC), and triglycerides (TG) of the two groups were analyzed, respectively, during the 6-month intervention.  Results  After 6-month of intervention, the medication compliance of the experimental group were significantly higher than that of the control group, and the blood pressure and adverse drug reaction rate were significantly lower than that of the control group. After 3 months of intervention, there was no significant decrease in BMI, FBG, TC and TG in the two groups. After 6 months of intervention, the FBG, TC and TG of the experimental group were significantly decreased, while only the FBG value of the control group was significantly decreased. There were no significant changes in body mass index (BMI) values in both groups.  Conclusions  Individualized medication guided by genotyping can improve the treatment compliance, reduce the adverse drug reaction rate, and improve the treatment efficiency of patients with essential hypertension.
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