CYP3A5基因多态性与双环醇保肝降酶效应的关系

Relationship between the genetic polymorphism of CYP3A5 gene and the Clinical response to bicycioi in chronic hepatitis B

目的研究CYP3A5酶基因多态性与双环醇保肝降酶作用临床效应的关系。方法34例慢性乙型肝炎患者在常规治疗的基础上予双环醇片治疗24周；治疗前后检测肝功能指标（ALT、AST）；采用PCR-RFLP法对患者CYP3A5酶基因型进行检测。结果将检测结果基因型为CYP3A5＊1（共16例，包括CYP3A5＊1/＊1型2例和CYP3A5＊1/＊3型14例）作为观察组，基因型为CYP3A5＊3组（即CYP3A5＊3/＊3型，18例）作为对照组。治疗后，CYP3A5＊1组和CYP3A5＊3组患者ALT、AST水平均有显著下降（P〈0．05）；CYP3A5＊3组患者的ALT和AST下降幅度分别为79．73％和74．76％，显著大于CYP3A5＊1组的65．90％和49．63％（P〈0．05）；治疗后，两组之间的ALT及AST相比差异有统计学意义（P〈0．05），CYP3A5＊3组ALT复常率和AST复常率均高于CYP3A5＊1组，差异有统计学意义（P〈0．05）。结论CYP3A5酶基因型对双环醇治疗慢性乙肝的临床疗效抗炎保肝降酶效应有明显影响，基因型为CYP3A5＊3的慢性乙肝患者双环醇疗效反应较强，该酶基因型可能成为双环醇疗效（尤其是降酶效应）的预测参照因子。

Objective To investigate the relationship between the genetic polymorphisms of CYP3A5 and the clinical effectiveness of Bicyclol on patients with chronic hepatitis B to make individual medication possible. Methods 34 cases of chronic hepatitis B were treated by bicyclol tablets for 24 weeks. Liver function indexes （ALT, AST）were determined before and after treatment. Blood CYP3 A5 genotyping of each patient was determined by the PCR-RFLP analysis. Results All subjects were genotyped for the CYP3A5 ＊ 3 gene and divided into different group. The groups comprised subjects with CYP3A5 ＊ 3 carriers（ n = 18） and CYP3A5 ＊ 1 carriers（ n = 16） which include CYP3A5 ＊ 1/＊ 1 （ n = 2）and CYP3A5 ＊ 1/＊ 3 （ n = 14）. Compared with pre-treatment,the serum ALT and AST levels were decreased obviouslyin all patients. The mean poreentage reduction of serum ALT and AST levels were significantly greater in subjects with CYP3A5 ＊ 3 carriers （79.73% and 74.76%） than in those with CYP3A5 ＊ 1 carriers （65.90% and 49.63%）（P 〈0.05）. The recovery rates of ALT and AST were significantly highter in CYP3A5 ＊ 3 carriers than those in CYP3A5 ＊ 1 carriers （P 〈 0.05 ）. Conclusion CYP3A5 genotypo has an impact on the therapeutic effects of Bicyclol. The subjects with CYP3A5 ＊ 3 carriers is more effective than the subjects with CYP3A5 ＊ 1 carriers. CYP3A5 genotyping may be helpful in predicting therapeutic effects of Bicyclol especially in the terms of decreasing ALT and AST.