摘要
目的探究ADRB2基因调控区多态性对短效β2受体激动剂(SABA)治疗儿童哮喘急性发作疗效的影响。方法选取2016年10月-2020年10月就诊于中国人民解放军北部战区总医院的急性轻中度发作且接受SABA治疗7 d的支气管哮喘患儿127例,检测其基因型分布,比较不同基因型患儿治疗后肺功能指标的改善情况和疗效,并考察基因多态性高阶交互作用对疗效的影响。结果127例患儿中,rs2895795位点TT、TA、AA型分别有80、44、3例,rs11168070位点CC、CG、GG型分别有93、32、2例,rs12654778位点GG、GA、AA型分别有41、64、22例,均符合Hardy-Weinberg平衡(P>0.05)。治疗后,rs2895795位点TA型患儿的最高呼气流量占预计值百分比(PEF%pred)、用力呼气75%肺活量时的瞬间流量占预计值百分比(FEF75%pred)改善率均显著低于TT型(P<0.05);rs11168070位点CG型患儿的PEF%pred、FEF75%pred改善率均显著低于CC型(P<0.05);rs12654778位点GA、AA型患儿的PEF%pred改善率均显著低于GG型(P<0.05)。各位点不同基因型患儿治疗前后呼出气一氧化氮差值比较,差异均无统计学意义(P>0.05)。rs2895795位点TT型患儿的显效比例是TA+AA型患儿的2.358倍(P<0.05),ADRB2基因多态性高阶交互作用对哮喘患儿的疗效没有明显影响(P>0.05)。结论支气管哮喘患儿ADRB2基因调控区多态性与SABA用于哮喘患儿急性发作的疗效相关,rs2895795、rs11168070、rs12654778位点野生型患儿的肺功能改善更明显,且rs2895795位点TT型患儿接受SABA治疗的效果更好。
OBJECTIVE To explore the effects of ADRB2 gene regulatory region polymorphism on the efficacy of short-acting beta 2 receptor agonists(SABA)in the treatment of acute asthma attack in children.METHODS A total of 127 children with acute mild to moderate bronchial asthma who received SABA treatment for 7 days in the General Hospital of Northern Theater Command from October 2016 to October 2020 were selected to detect their genotype distribution and compare the improvement of pulmonary functional indicators and curative effect among different genotypes.The effect of the high-order interaction of gene polymorphism on therapeutic effect was investigated.RESULTS Among 127 children,there were 80,44 and 3 cases of TT,TA and AA types at locus rs2895795,93,32 and 2 cases of CC,CG and GG types at locus rs11168070,and 41,64 and 22 cases of GG,GA and AA types at locus rs12654778,respectively,in accordance with Hardy-Weinberg equilibrium(P>0.05).After treatment,the improvement rate of the peak expiratory flow in percent predicted value(PEF%pred)and the improvement rate of the forced expiratory flow at 75%vital capacity in percent predicted value(FEF75%pred)in children with TA type were significantly lower than that of TT type at locus rs2895795(P<0.05);the improvement rates of PEF%pred and FEF75%pred in children with CG type were significantly lower than that of CC type at locus rs11168070(P<0.05);the improvement rates of PEF%pred in children with GA and AA type were significantly lower than that of GG type at locus rs12654778(P<0.05).The differences in fractional exhaled nitric oxide before and after treatment were not statistically significant among different genotypes at each locus(P>0.05).The proportion of remarkable improvement of children with TT type at locus rs2895795 was 2.358 times that of children with TA+AA type(P<0.05),and there was no significant effect of higher-order interaction of ADRB2 polymorphism on the efficacy in children with asthma(P>0.05).CONCLUSIONS Polymorphisms in the regulatory region of the ADRB2 gene in children with bronchial asthma are associated with the efficacy of SABA in the treatment of acute asthma attack in children.At locus rs2895795,rs11168070 and rs12654778,the improvement of lung function of children with wild-type is more obvious,and the efficacy of SABA treatment on children with TT type is better at locus rs2895795.
作者
张世楠
魏兵
蔡明轩
廖世峨
尤瑄
支艳杰
ZHANG Shinan;WEI Bing;CAI Mingxuan;LIAO Shie;YOU Xuan;ZHI Yanjie(Dept.of Neonatology,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《中国药房》
CAS
北大核心
2023年第6期714-718,723,共6页
China Pharmacy
基金
辽宁省民生科技计划项目(No.2021JH2/10300060)
沈阳市科技计划项目(No.20-205-4-062)。
