美托洛尔对CYP2D6和β1-肾上腺素受体基因型一致的高血压病患者降压疗效差异的相关因素分析

Analysis of Related Factors to Different Antihypertensive Effective Rate of Metoprolol with the Same Genotypes of CYP2D6 and β1-Adrenergic Receptor

目的探讨美托洛尔对CYP2D6和β1-肾上腺素受体基因型一致的高血压病患者降压疗效差异的相关因素。方法筛选CYP2D6*10位基因型为*10*10且β1-肾上腺素受体389位基因型为Arg/Arg的原发性高血压患者63例,给予美托洛尔100mg/d治疗,2周随访一次观察血压、心率变化,8周后分析年龄、基线血压、体质指数、高脂血症、吸烟等因素和美托洛尔降压疗效的关系。结果63例患者中美托洛尔降压总有效者40例,无效者23例,总有效率为63.5%。单因素分析显示,基线收缩压和体质指数显著影响美托洛尔降压疗效(P<0.05)。多因素分析显示,基线收缩压对美托洛尔降压疗效影响最大。结论基线血压和体质指数是导致CYP2D6和β1-肾上腺素受体基因型一致的高血压病患者美托洛尔降压疗效差异的重要原因。

Aim To investigate the influence of ralated factors to different antihypertensive effective rate of metoprolol with the same genotypes of CYP2D6 and β1-adrenergic receptor （β1-AR）. Methods 63 cases of 1 or 2 grade essential hypertension patients with the ＊10＊10 of CYP2D6＊10 genotype and Arg/Arg of β1-AR Gly389Arg genotype were chosen and administrated with metoprolol 100 mg/d. Indexes, such as blood pressure and heart rate, were collected every two weeks during the follow-up visit. After 8 weeks, the relationships between the related factors, such as age, baseline blood pressure, body mass index （BMI）, hyperlipidemia and smoking, and antihypertensive effective rate of metoprolol were analysed. Results According to antihypertensive efficacy, 40 patients were effective to metoprolol, while 23 were ineffective. The effective rate was 63.5%. Monofactorial analysis indicated that patients with higher baseline systolic blood pressure and normal BMI had greater effective rate than the others （P〈0.05）. Furthermore, multifactoring regression analysis also claimed that baseline systolic blood pressure showed the significant effect to metoprolol. Conclusion Baseline blood pressure and BMI are related to the different antihypertensive effective rate of metoprolol.