H型高血压伴MTHFR基因突变的药学监护

Pharmaceutical Care on an H Hypertension Case with MTHFR Gene Mutation

目的探讨临床药师在个体化降血压中的作用。方法回顾临床药师参与1例H型高血压治疗案例。结果患者MTHFR(C677T)基因型为TT型突变纯合型,临床药师建议医生修改治疗方案,患者血浆同型半胱氨酸由61.5μmol·L^(-1)降至16.0μmol·L^(-1),血压由173/111 mm Hg(1 mm Hg=0.133 k Pa)降至130/80 mmHg。结论临床药师通过基因检测为患者提供个体化降压方案,保障患者用药安全、有效。

Objective To explore the role of clinical pharmacist in individualized treatment of hypertension. Methods A patient with ＂ H＂ hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed. Results Patient s MTHFR （ C677T） gene type was TT homozygous. Clinical pharmacist suggested doctor modify treatment, and then patients plasma homocysteine dropped from 61.5 to 16.0 μmol·L^-1 , and blood pressure dropped from 173/ 111 mmHg（l mmHg =0.133 kPa） to 130/80 mmHg. Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.