摘要
目的：探讨不同CYP2C9基因型的2型糖尿病服用磺脲类药物后的达标情况.方法：对283例2型糖尿病患者进行CYP2C9基因型检测,检测出CYP2C9＊1/＊1野生型个体及CYP2C9＊1/＊3突变型个体.入选患者分成CYP2C9＊1/＊1野生型组和CYP2C9＊1/＊3突变型组,所有患者均单独使用磺脲类药物治疗（使用的磺脲类药物包括格列美脲2 mg、格列齐特缓释片30 mg、格列吡嗪5 mg）.比较两组患者治疗前、治疗后3个月末及6个月末的空腹血糖（FPG）、餐后2 h血糖（2HPG）和糖化血红蛋白（GHbA1c）达标情况.结果：CYP2C9＊1/＊3突变型组患者[治疗后6个月空腹血糖（6.27±0.62）mmol/L、GHbA1c（6.46±0.62）mmol/L]比CYP2C9＊1/＊1野生型组患者[治疗后6个月空腹血糖（7.04±0.97）mmol/L、GHbA1c（6.96±0.68）mmol/L]具有更高的达标率.结论：在治疗前检测2型糖尿病患者的CYP2C9基因型,能指导选择治疗方案,对于CYP2C9＊1/＊3突变型个体选用磺脲类药物.在避免低血糖发生的情况下可更有效控制患者的空腹血糖（FPG）、餐后2 h血糖（2HPG）和糖化血红蛋白（GHbA1c）的水平.
Objective： To investigate the laboratory outcomes after sufonylureas medication in type 2 diabetes patients with different CYP2C9 genotypes. Methods：From 283 patients with type 2 diabetes, subjects I with wild-type variant （CYP2C9 ＊ 1/＊ 1 ） or heterozygous mutant （CYP2C9 ＊ 1/＊ 3 ） of th6 CYP2C9 genotypes were screened and recruited in this study. The patients were then divided into the CYP2C9 ＊ 1/＊ 1 wild-type group and CYP2C9 ＊ 1/＊ 3 heterozygous mutant group, and were instructed to be on self-initiated medication with sufonylureas （ SU ）, which included any of 2 mg glimepiride, 30mg sustained-release gliclazide and 5 mg glipizide. Fasting plasma glucose （FPG）, 2-hour postprandial blood glucose （2HPG） and glycosylated hemoglobin （GHbAlc） were then compared between the two groups before treatment, 3 months and 6 months after treatment. Results： At 6 months after treatment, the CYP2C9 ＊ 1/＊ 3 heterozygous mutant group [ FPG： （6. 27 ± 0.62） mmol/L ; GHbAI c ： （ 6.46 ± 0. 62） mmol/L] had a higher rate of blood glucose control than did the CYP2C9 ＊ 1/＊ 1 wild-type group [ FPG ： （ 7.04 ± 0.97 ） mmol/L ; GHbA1 c （ 6.96 ± 0.68 ） mmol/L ]. Conclusion：Detection of CYP2C9 genotypes before treatment appeared helpful in guiding selection of therapy. For CYP2C9 ＊ 1/＊ 3 heterozygous mutants, SU medication with cautions against hypoglycemia should be more effective in control of FPG,2HPG and GHbAlc.
出处
《广州医学院学报》
2010年第6期10-13,共4页
Academic Journal of Guangzhou Medical College
