【摘要】 目的 研究促肾上腺皮质激素释放激素受体1(CRHR1)基因rs242941位点的多态性与哮喘儿童吸入性糖皮质激素(ICS)长期安全用药的关系。方法 选取2018年10月至2020年10月该院收治的100例哮喘儿童，均接受ICS治疗及常规对症治疗。采用TaqMan法检测CRHR1基因rs242941位点多态性，根据基因型分为GG、GT+TT,比较不同基因型患儿的肺功能、哮喘控制测试评分及不良反应发生情况。采用多因素Logistic回归分析影响哮喘儿童ICS安全用药的危险因素。结果 CRHR1基因rs242941位点存在3种基因型：GG(72例)、GT(20例)、TT(8例),G和T等位基因频率分别为82%和18%。治疗12周后不同基因型患儿的哮喘控制测试评分、第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)比值与治疗前比较均明显提升，其中GG基因型患儿改善情况优于GT+TT基因型，GG基因型患儿的症状及体征完全缓解时间明显短于GT+TT基因型，差异有统计学意义(P<0.05)。GG基因型不良反应发生率低于GT+TT基因型，差异有统计学意义(P<0.05)。单因素、多因素Logistic回归分析显示，rs242941位点基因型多态性是影响患者用药安全的独立危险因素(P<0.05)。结论 CRHR1基因rs242941位点多态性与哮喘儿童ICS的疗效及长期用药安全性密切关联，其中TT基因型患儿具有更高的ICS不良反应发生风险。更多还原

【Abstract】 Objective To study the relationship between the polymorphism of corticotropin releasing hormone receptor 1(CRHR1) gene rs242941 and long-term safe use of inhaled glucocorticoids(ICS) in children with asthma.Methods 100 children with asthma admitted to a hospital from October 2018 to October 2020 were selected and all received glucocorticoid therapy and conventional symptomatic treatment.The TaqMan method was used to detect the CRHR1 gene rs242941 polymorphism.According to the genotype, they were divided into GG and GT+TT.The lung function, asthma control test scores and the occurrence of adverse reactions were compared in children with different genotypes.Multivariate Logistic regression analysis was used to analyze the risk factors affecting the safe use of ICS in children with asthma.Results There were three genotypes at the rs242941 locus of CRHR1 gene: GG(72 cases),GT(20 cases),and TT(8 cases).The frequencies of G and T alleles were 82% and 18%,respectively.After 12 weeks of treatment, the asthma control test scores, forced expiratory volume in the first second(FEV1) and FEV1/forced vital capacity(FVC) ratio of children with different genotypes were significantly improved compared with those before treatment, and the improvement of children with GG genotype was better than that with GT+TT genotype.The complete remission time of symptoms and signs in GG genotype was significantly shorter than that in GT+TT genotype, and the difference was statistically significant(P<0.05).The incidence of adverse reactions of GG genotype was lower than GT+TT genotype, and the difference was statistically significant(P<0.05).Univariate and multivariate logistic regression analysis showed that rs242941 genotype polymorphism was an independent risk factor for drug safety(P<0.05).Conclusion The rs242941 polymorphism of CRHR1 gene is closely related to the efficacy and long-term safe use of ICS in asthmatic children, and children with TT genotype have a higher risk of adverse reactions to ICS.更多还原