【摘要】 目的分析高血压人群的降压药物基因敏感性,基因导向个体化选择降压药物,为高血压患者提供精准药物治疗。方法选取2016年1月至2017年9月宜宾市第二人民医院老年医学科就诊的157例初发高血压患者,其中研究组54例,对照组103例,对研究组进行高血压药物靶点基因检测,筛查降压药物基因敏感性靶点;研究组基因导向个体化选择降压药物,对照组经验性选择降压药物,比较研究组与对照组降压药物的临床疗效。药物敏感情况用率表示,采用t检验比较2组间年龄、体质量指数、肝肾功、血脂、血压水平、心率、血压稳定时间以及药物种类的差异,采用χ~2检验比较2组间性别、不良反应的差异。结果研究组54例患者中,总人群对钙通道阻滞剂类降压药敏感性较好,强阳性率达98.1%,对β受体阻滞剂敏感强阳性率达70.3%,总人群对血管紧张素转换酶抑制剂敏感性一般,有效率达70.4%,而对血管紧张素Ⅱ受体拮抗剂、利尿剂的敏感性欠佳。基因导向个体化用药后,研究组与对照组血压均达标,血压达标时间研究组高于对照组为[(4.58±1.17)d vs(5.14±1.03)d],差异具有统计学意义(t=-2.06,P=0.04),使用药物个数少于对照组[(1.48±0.50)个vs(1.52±0.52)个],差异具有统计学意义(t=-0.18,P=0.86),2组间不良反应比较差异无统计学意义(P> 0.05),而研究组心率下降更明显,治疗后研究组心率低于对照组[(68.33±1.62)vs(74.54±2.14)],差异具有统计学意义(t=-1.73,P=0.04)。结论对高血压需要降压药物治疗人群,从基因敏感性角度可选用钙通道阻滞剂、β受体阻滞剂类降压药物,基因导向个体化选择降压药物更有利于血压的控制。更多还原

【Abstract】 Objective To analyze the gene sensitivity to antihypertensive drugs, conduct gene-oriented selection of individualized medications, and give accurate drug treatment for patients with hypertension. Methods One hundred and ?fty-seven incipient hypertension patients were included from January 2016 to September 2017 and divided into either a study group(54 cases) or a control group(103 cases). All patients in the study group underwent genetic testing for gene sensitivity to antihypertensive drugs, and antihypertensive drugs were selected according to the results of gene testing. In the control group,antihypertensive drugs were selected empirically. Clinical ef?cacy of antihypertensive drugs were compared between the two groups. Drug sensitivity is expressed as composition ratio. The t-test was used to compare age, body mass index, liver and kidney function, blood lipids, blood pressure, heart rate, blood pressure stability time and drug types among the groups, and gender and the number of adverse reactions were compared using the chi-square test. Results Of the 54 cases in the study group, 98.1% were sensitive to CCB, 70.3% sensitive to beta-blockers, 70.3% to ACEI, and no patients were sensitive to ARB and diuretics.After treatment, blood pressure decreased in both groups, the normal blood pressure time in the study group and control group was(4.58±1.17) vs(5.14±1.03)(P < 0.05), and the number of drugs used was(1.48±0.50) vs(1.52±0.52)(t=-0.18, P=0.86). The adverse reactions of antihypertensive drugs between the two groups had no statistical signi?cance(P > 0.05). Heart rate decreased signi?cantly in the study group compared with the control group [(68.33±1.62) vs(74.54±2.14, P < 0.05]. Conclusion Hypertension patients requiring antihypertensive drug treatment can choose CCB and beta-blockers based on gene testing results. Gene-oriented individualized selection of antihypertensive drugs is more conducive to the control of blood pressure.更多还原