【摘要】 背景 CYP2D6基因多态性与心血管疾病有关,但其与文法拉辛(VEN)相关性心肌病严重程度的关系鲜有报道。目的探讨CYP2D6基因多态性与VEN相关性心肌病严重程度的关系。方法选取2012年1月—2018年1月滕州市中心人民医院收治的VEN相关性心肌病患者50例,均给予常规治疗。比较不同CYP2D6基因型患者治疗前及治疗7 d后血浆N末端B型利钠肽前体(NT-proBNP)、C反应蛋白(CRP)、糖类抗原125(CA125)水平及超声心动图检查指标〔包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)〕,并比较不同CYP2D6基因型患者心功能改善有效率。结果 (1)CYP2D6*2具有3种基因型,分别为CC(n=14)、CT(n=17)和TT(n=19);CYP2D6*4基因型均为GG;CYP2D6*10具有3种基因型,分别为CC(n=18)、CT(n=17)和TT(n=15)。(2)不同CYP2D6*2基因型患者治疗前、治疗7 d后血浆NT-proBNP、CRP、CA125水平,LVEF,LVEDD及其差值比较,差异无统计学意义(P>0.05)。(3)CYP2D6*10基因型为TT者治疗前及治疗7 d后血浆NT-proBNP水平低于CC、CT者,LVEF高于CC、CT者,LVEDD短于CC、CT者(P<0.05);CYP2D6*10基因型为TT者血浆NT-proBNP水平、LVEDD、LVEF治疗前及治疗7 d后差值大于CC、CT者(P<0.05);不同CYP2D6*10基因型患者治疗前及治疗7 d后血浆CRP、CA125水平比较,差异无统计学意义(P>0.05)。(4)不同CYP2D6*2基因型患者心功能改善有效率比较,差异无统计学意义(P>0.05);CYP2D6*10基因型为TT者心功能改善有效率高于CC、CT者(P<0.05)。结论 CYP2D6基因多态性可能与VEN相关性心肌病患者严重程度有关,其中CYP2D6*10基因型为TT的VEN相关性心肌病患者疾病严重程度最低,对治疗反应最好。更多还原

【Abstract】 Background Gene polymorphism of CYP2D6 is significantly correlated with cardiovascular disease,but its relation to venlafaxine(VEN)-associated cardiomyopathy is rarely reported. Objective To investigate the relationship between gene polymorphism of CYP2D6 and severity of VEN-associated cardiomyopathy. Methods A total of 50 patients with VEN-associated cardiomyopathy were selected in the Central People’s Hospital of Tengzhou from January 2012 to January 2018,and all of them were given conventional treatment. Plasma levels of NT-proBNP,CRP and CA125 and echocardiography examination results(including LVEF and LVEDD)were compared in patients with different genotypes of CYP2D6 before treatment and 7 days after treatment,and improvement rate of cardiac function was compared in patients with different genotypes of CYP2D6,too. Results (1)There were three genotypes of CYP2D6*2,including CC genotype(n=14),CT genotype(n=17)and TT genotype(n=19);genotype of CYP2D6*4 was GG only;there were three genotypes of CYP2D6*10,including CC genotype(n=18),CT genotype(n=17)and TT genotype(n=15).(2)There was no statistically significant difference in plasma levels of NT-proBNP,CRP or CA125,LVEF,LVEDD or their differential value in patients with different genotypes of CYP2D6*2 before and 7 days after treatment(P>0.05).(3)Plasma NT-proBNP level in patients with TT genotype of CYP2D6*10 was statistically significantly lower than that in patients with CC or CT genotype before and 7 days after treatment,LVEF in patients with TT genotype of CYP2D6*10 was statistically significantly higher than that in patients with CC or CT genotype before and 7 days after treatment,while LVEDD in patients with TT genotype of CYP2D6*10 was statistically significantly shorter than that in patients with CC or CT genotype before and 7 days after treatment,respectively(P<0.05);differential value of plasma NT-proBNP level,LVEF and LVEDD in patients with TT genotype of CYP2D6*10 was statistically significantly larger than that in patients with CC or CT genotype,respectively(P<0.05);no significant difference of plasma levels of CRP or CA125 was found in patients with different genotypes of CYP2D6*10 before and 7 days after treatment(P>0.05).(4)No statistically significant difference of improvement rate of cardiac function was found in patients with different genotypes of CYP2D6*2(P>0.05),while improvement rate of cardiac function in patients with TT genotype of CYP2D6*10 was statistically significantly higher than that in patients with CC or CT genotype,respectively(P<0.05). Conclusion Polymorphism of CYP2D6 is possibly related to the severity of VEN-associated cardiomyopathy,moreover severity of VENassociated cardiomyopathy is the lowest and the response to treatment was the best in patients with TT genotype of CYP2D6*10.更多还原