摘要
目的:分析湖南省长沙县辖区抗高血压药物相关基因在高血压病人群中的分布特征,为该地区高血压病患者个体化治疗提供参考,提高抗高血压治疗的经济效益。方法:选取2017年长沙县各乡镇卫生院以及街道卫生服务中心登记的高血压患者29 935例为调查对象。采用口腔黏膜拭子的方法进行DNA标本收集,应用基因芯片法对目前国内外已达成共识的5大类降压药物(β受体阻滞剂、血管紧张素Ⅱ受体拮抗剂、血管紧张素转化酶抑制剂、利尿剂、钙通道阻滞剂)的7个基因多态位点(CYP2D6*10、ADRB1、CYP2C9*3、AGTR1、ACE、NPPA和CYP3A*3)进行检测分型,研究分析长沙县区高血压基因型频率分布情况。结果:29 935例高血压患者中CYP2D6*10突变率为57.15%,ADRB1(1165G>C)为74.47%,CYP2C9*3为4.25%,AGTR1(1166A>C)为5.70%,ACE(I/D)为31.64%,NPPA(2238T>C)为1.17%,CYP3A5*3为69.55%。结论:与国内外研究数据相比较,长沙县区大多数高血压人群对β受体阻滞剂、钙通道阻滞剂的反应较为敏感,对血管紧张素转化酶抑制剂和血管紧张素Ⅱ受体拮抗剂的反应属正常水平,而对利尿剂的反应较差,临床使用上述药物时应适当调整剂量。
Objective:To analyze the distribution of polymorphisms of antihypertensive drug related genes in Changsha area of Hunan province.Method:This study enrolled 29 935 patients with essential hypertension registered in township hospitals and community health service centers in Changsha County in 2017.Specimens were collected from oral mucosa,then 7 gene locus(CYP2 D6*10,ADRB1,CYP2 C9*3,AGTR1,ACE,NPPA and CYP3 A5*3)which related to the efficacy of five classes of antihypertensive drugs(β-receptor block,angiotensinⅡreceptor antagonist(ARB),angiotensin converting enzyme inhibitor(ACEI),diuretic and calcium channel blocker)were tested by gene microarray method,and the related gene distribution in the population was analyzed.Result:In 29 935 patients with essential hypertension,the frequency of CYP2 D6*10,ADRB1(1165 G>C),CYP2 C9*3,AGTR1(1166 A>C),ACE(I/D),NPPA(2238 T>C)and CYP3 A*3 mutant allele was 57.15%,74.47%,4.25%,5.70%,31.64%,1.17%and 69.55%,respectively.Conclusion:The present study suggested that in the large majority hypertensive patients in Changsha County,the sensitivity toβ-receptor block or calcium channel blocker is high,the response to ACEI or ARB is normal,whereas it is poor to diuretic.Appropriate dosage should be adjusted in the clinical use of above drugs.
作者
杨梅
肖智林
陈晓彬
谢秀梅
方立
陈美芳
YANG Mei;XIAO Zhilin;CHEN Xiaobin;XIE Xiumei;FANG Li;CHEN Meifang(Department of Geriatrics,Xiangya Hospital,Central South University,National Clinical ResearchCenter For Geriatric Disorders(Xiangya),Changsha,Hunan410008,China;Departmentof Cardiology,the first Hospital of Changsha)
出处
《临床心血管病杂志》
CAS
北大核心
2019年第6期559-563,共5页
Journal of Clinical Cardiology
关键词
高血压病
抗高血药物相关基因
基因多态性
hypertension
antihypertensive drug related genes
gene polymorphism
