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降压药物相关基因多态性在某院高血压患者中的应用研究
引用本文:张露潆,付士辉,陈羽翔,甯超学,杨婷,陈玉剑,朱乔,赵亚力.降压药物相关基因多态性在某院高血压患者中的应用研究[J].中国热带医学,2022,22(11):1066-1072.
作者姓名:张露潆  付士辉  陈羽翔  甯超学  杨婷  陈玉剑  朱乔  赵亚力
作者单位:1.海南医学院基础医学与生命科学学院,海南 海口 571100;2.解放军总医院海南医院心内科,海南 三亚 572013;3.海南医学院第一临床学院,海南 海口 570100;4.解放军总医院海南医院热带医学研究所研究室,海南 三亚 572013
基金项目:海南省自然科学基金(No. 821QN389);国家人类遗传资源中心(No. YCZYPT[2018]07);海南省院士创新平台科研专项(No.YSPTZX202216)
摘    要:目的 分析来我院就诊高血压患者中降压药物相关基因型的频率分布,为高血压患者个体化治疗提供参考和临床依据。方法 收集2021年6月—2022年4月在中国人民解放军总医院海南医院就诊的高血压患者,共72例。采用PCR-熔解曲线法检测CYP2D6*10(c.100 C>T)、CYP2C9*3(c.1075 A>C)、ADRB1(c.1165 G>C)、AGTR1(c.1166 A>C)、ACE(I/D)、NPPA(T2238C)和CYP3A5*3(A6986G),并分析不同基因型与生化指标的关系。结果 对72例患者各位点基因及基因型频率进行统计,7个位点基因频率均符合Hardy-Weinberg平衡。ADRB1基因型存在性别差异(χ2=5.878, P<0.05)。AGTR1位点不同基因型的患者之间三酰甘油AA:1.4(1.0, 2.0)mmol/L;AC:2.2(1.5, 2.5)mmol/L;P=0.038]、总胆固醇AA:4.0(3.1, 4.9)mmol/L;AC:4.8(4.0, 5.3)mmol/L;P=0.040]、低密度...

关 键 词:高血压  基因检测  个体化治疗  降压药
收稿时间:2022-05-23

Antihypertensive drug-related genes polymorphisms in hypertensive patients at a certain hospital
ZHANG Lu-ying,FU Shi-hui,CHEN Yu-xiang,NING Chao-xue,YANG Ting,CHEN Yu-jian,ZHU Qiao,ZHAO Ya-Li.Antihypertensive drug-related genes polymorphisms in hypertensive patients at a certain hospital[J].China Tropical Medicine,2022,22(11):1066-1072.
Authors:ZHANG Lu-ying  FU Shi-hui  CHEN Yu-xiang  NING Chao-xue  YANG Ting  CHEN Yu-jian  ZHU Qiao  ZHAO Ya-Li
Institution:1. School of basic medicine and Life Sciences, Hainan Medical University, Haikou, Hainan 571100, China;2. Department of Cardiology, Hainan Hospital of PLA General Hospital, Sanya, Hainan 572013, China;3. The First Clinical School, Hainan Medical University, Haikou, Hainan 570100, China;4. Institute of Tropical Medicine Research Unit, Hainan Hospital of PLA General Hospital, Sanya, Hainan 572013, China
Abstract:Objective By analyzing the frequency distribution of antihypertensive drug-related genotypes in hypertensionpatients treated in our hospital, so as to provide a clinical basis for individualized treatment of hypertension patients. Methods A total of 72 hypertensive patients treated in Hainan Hospital of PLA General Hospital from June 2021 to April 2022 were collected. PCR-melting curve method was used to detect CYP2D6*10 (c.100 C>T), CYP2C9*3 (c.1075 A>C), ADRB1 (c.1165 G>C), AGTR1 (c.1166 A>C), ACE (I/D), NPPA (T2238C) and CYP3A5*3 (A6986G), and the relationship between different genotypes and biochemical indexes was analyzed. Results According to the statistics of the gene and genotype frequency of each point in 72 patients, the gene frequencies of 7 sites all conformed to Hardy Weinberg equilibrium. There were gender differences in ADRB1 genotypes (χ2 = 5.878, P<0.05). There were statistical differences in triglycerides AA: 1.4 (1.0, 2.0)mmol/L; AC: 2.2 (1.5, 2.5)mmol/L; P=0.038], total cholesterol AA: 4.0 (3.1, 4.9) mmol/L; AC: 4.8 (4.0, 5.3) mmol/L; P=0.040] and low-density lipoprotein cholesterol (AA: 2.4 (1.8, 3.3) mmol/L; AC: 3.2 (2.5, 3.5) mmol/L; P=0.035] among patients with different genotypes of AGTR1 locus. The patients with different genotypes of CYP2C9 locus had significant differences in their alanine transferase (ALT) AA:16.9 (11.4,30.2) mmol/L; AC:10.4 (9.4, 18.2) mmol/L; P=0.040]. Aftergene-directed individualized therapy, different genotypes of CYP3A5 andAGTR1 affected the heart rate CYP3A5: AA: (79.3±7.0) beats/min; AG (69.8±6.8) beats/min; GG (68.8±7.3) beats/min; P=0.010], systolic blood pressure AGTR1: AA: (131.3±16.7) mmHg; AC: (140.6±11.8) mmHg; P=0.014] and diastolic blood pressure CYP3A5: AA: (90.0±8.3) mmHg; AG: (78.7±10.8) mmHg; GG: (74.9±10.7) mmHg; P=0.025; AGTR1: AA: (75.3±10.2) mmHg; AC: (86.3±10.6) mmHg; P=0.001] of patients. Conclusions The related gene loci of antihypertensive drugs are an important basis for guiding the diversification and individualization of clinical medication. Clinicians need to consider the impact of related genes on drug efficacy and adverse reactions when prescribing.
Keywords:Hypertension  genetic testing  individualized treatment  anti-hypertension medications  
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