基因芯片检测方法检测抗高血压药物相关基因20例

Observation Study on Gene Detection for Hypertensive Drugs with Gene Chip Method

目的用基因芯片检测的方法检测抗高血压药物的相关基因，指导抗高血压药物的个性化给药方式，提高用药有效率，减少不良反应的发生。方法原发性高血压患者20例，高血压病史3～20a，服用药物为：血管紧张肽Ⅱ受体（AT1）拮抗药类（如洛沙坦、依贝沙坦、缬沙坦等）；β受体阻断药（如美托洛尔、阿替洛尔等）；血管紧张肽转换酶抑制药（ACEI，如依那普利、贝那普利等）。抽取患者血液2mL，用基因芯片对与抗高血压药物相关的5个位点进行检测。野生型纯合子判读为“WW”，杂合子判读为“WM”，突变型纯合子判读为“MM”。结果5个抗高血压药物相关基因检测位点的“WW”“WM”“MM”所占比例分别为：CYP2C9位点（85％，15％，0％），B受体位点（15％，40％，45％），AT1位点（80％，20％，0％），CYP2136位点（25％，20％，55％），ACEI位点（40％，40％，20％）。结论CYP2C9及AT1位点基因型分析用于给出AT1受体阻断药；CYP2D6及β受体位点基因型用于给出β受体阻断药；ACEI位点用于给出ACEI类药物的个体化给药方案和预测不良反应的发生风险。该方法用于临床原发性高血压患者的基因型检测，能够大大提高药物使用的有效率，并有效降低不良反应发生率，值得临床推广使用。

Objective To study the gene polymorphisms of hypertension drug＇s related gene in hypertension patients. Methods Twenty patients with hypertension history from 3 to 20 years, who were treated by AT1 -receptor antagonism （for instance ： losartan, irbesartan, valsartan） , β-receptor block （for instance ： metoprolol, atenoIol ） , ACE inhibitors （ for instance ： enalapril, benazepril）were collected. DNA was extracted form 2 mL peripheralblood. 5 hypertensionrelated gene sites were detected by gene chip. Results In 20 hypertensive patients, rates of wide genotype, heterozygote and mutated genotype in CYP2C9 gene site were 85% ,15%and 0% ,respectively; in β-receptor block site were 15% ,40% and 45% ; in AT1-receptor site were 80% ,20% and 0% ;in CYP2D6 site were 25% ,20% and 55% ;and in hierarchize ACEI site were 40% ,40% and 20%, respectively. Conclusion The gene type detection based on gene chip might classify hypertensive patients to provide more effective therapy and lower ADR.