比索洛尔按基因导向治疗高血压的疗效

目的：探讨比索洛尔按CYP2D6及CYP3A4基因导向治疗高血压的疗效。方法：选择100例原发性高血压患者，随机抽取20例进行常规药物治疗（比索洛尔5mg/d ）。余80例患者分为 A、B两组，各40例，根据CYP2D6倡10（A组）及CYP3A4倡1G （B组）基因多态性检测结果分为ACC组（13例）、ACT组（14例）、ATT组（10例），BCC组（21例）、BCT组（17例）、BTT组（0例）。根据测定基因型调整比索洛尔用量， ACC组、BCC组给予10mg/d、ACT组、BCT组给予5mg/d、ATT组、BTT组给予2.5mg/d ，二周后测定各组血药浓度，血压值及心率等相关指标，评价比索洛尔血药浓度与药物代谢酶基因多态性的关系。结果：相同剂量比索洛尔：ACT组与常规治疗组比较，血药浓度，心率，血压等指标无统计学差异（P均＞0.05）；而BCT组与常规治疗组比较，血药浓度[（50.13±23.21） ng/ml比（33.5±19.1） ng/ml]显著升高，心率[（66.5±6.04）次/min比（71.4±5.16）次/min]、血压[（119.48±11.97/71.2±10.30） mmHg比（127.22±10.44/82.4±7.27） mmHg]显著降低（P均＜0.05）。结论：因基因多态性比索洛尔治疗高血压的疗效不一，进行基因导向治疗可显著提高对高血压的疗效。

Therapeutic effect of bisoprolol with gene targeting therapy for hypertension

Objective：To explore therapeutic effect of bisoprolol with CYP2D6 and CYP3A4 gene targeting therapy for hypertension .Methods ：A total of 100 cases with essential hypertension （EH） were selected ,among them 20 ca-ses were randomly chosen to receive routine medication （bisoprolol 5 mg/d ,routine treatment group ） ,the other 80 patients were equally divided into group A （CYP2D6＊10） and group B （CYP3A4＊1G） .According to detection results of CYP2D6＊10 and CYP3A4＊1G gene polymorphism ,they were dived into group ACC （n=13） ,group ACT （n=14） ,group ATT （n=10） ,group BCC （n=21） ,group BCT （n=17） and group BTT （n=0） .Bisoprolol dosage was adjusted according to genotypes ：group ACC and group BCC received 10 mg/d ,group ACT and group BCT received 5 mg/d ,group ATT and group BTT received 2.5 mg/d .Blood drug concentration ,blood pressure and heart rate were compared among above groups after two weeks .Relationship between plasma concentration of bisoprolol and gene polymorphism of drug metabolism enzyme was evaluated .Results：Comparison between related groups with same bi-soprolol dosage ：there were no significant difference in blood drug concentration ,heart rate and blood pressure be-tween ACT and routine treatment group , P〉0.05 all;compared with routine treatment group ,there was significant rise in blood drug concentration [ （33.5 ± 19.1） ng/ml vs .（50.13 ± 23.21） ng/ml] ,significant reduction in heart rate [ （71.4 ± 5.16） times/min vs .（66.5 ± 6.04） times/min] and blood pressure [ （127.22 ± 10.44/82.4 ± 7.27） mmHg vs .（119.48 ± 11.97/71.2 ± 10.30） mmHg] in BCT group , P〈0.05 all .Conclusion：Because gene possesses polymorphism ,therapeutic effect of bisoprolol treating hypertension is differing ;the gene targeting therapy may significantly improve therapeutic effect for hypertension .