急性脑梗死患者细胞色素P4502D6基因多态性对阿托伐他汀调脂疗效的影响

Effect of CYP2D6 gene polymorphism on lipid-lowering efficacy of atorvastatin in acute cerebral infarction patients

目的探讨急性脑梗死患者细胞色素P450(CYP)2D6rs1065852位点基因多态性与阿托伐他汀疗效的相关性。方法选择2015年11月~2016年3月我院收治的急性脑梗死患者192例为观察组,另选择同期门诊体检者192例为对照组。检测所有研究对象rs1065852位点基因多态性分布。分析阿托伐他汀治疗3个月后,观察组血脂水平的变化情况。结果观察组高血压、冠心病、饮酒、吸烟及TG水平明显高于对照组(P<0.01),HDL-C水平明显低于对照组[(1.11±0.31)mmol/L vs(1.17±0.35)mmol/L,P=0.049]。2组的等位基因分布及基因型比较无差异,且2组男性携带等位基因A频率与女性比较无差异(P>0.05)。与治疗前比较,阿托伐他汀治疗3个月后观察组GG、GA、AA基因型患者TC、TG及LDL-C水平明显下降,而HDL-C水平明显上升,差异有统计学意义(P<0.05)。治疗3个月后,GG基因型LDL-C水平明显低于GA和AA基因型[(1.05±0.25)mmol/Lvs(1.87±0.45)mmol/L和(1.89±0.12)mmol/L,P<0.01]。结论 CYP2D6rs1065852基因多态性与急性脑梗死患者阿托伐他汀调脂疗效有关,监测该基因多态性有助于预测阿托伐他汀的疗效。

Objective To study the association between CYP2 D6 rs1065852 gene polymorphism and lipid-lowering efficacy of atorvastatin in ACI patients.Methods One hundred and ninety-two ACI patients served as an observation group and 192 persons undergoing physical examination served as a control group.The distribution of CYP2 D6 rs1065852 gene polymorphism was detected in 2 groups.The blood-lipid level was analyzed in 2 groups after 3 months of treatment.Results The incidence of hypertension and coronary heart disease was significantly higher,the history of alcohol drinking and smoking was significantly longer,the serum level of TG was significantly higher while that of HDL-C was significantly lower in observation group than in control group（P〈0.05,P〈0.01）.A significant difference was found in distribution of allele gene and types of gene and in frequency of allele gene A in male and female carriers between the 2 groups（P〈0.05）.The serum levels of TC,TG and LDL-C were significantly lower while those of HDL-C were significantly higher in GG,GA and AA genotype carriers after 3 months of treatment than before treatment（P〈0.05）.The serum level of LDL-C was significantly lower in GG genotype carriers than in GA and AA genotype carriers after 3 months of treatment（1.05±0.25 mmol/Lvs 1.87±0.45 mmol/L vs 1.89±0.12 mmol/L,P〈0.01）.Conclusion CYP2 D6 rs1065852 gene polymorphism is associated with lipid-lowering efficacy of atorvastatin in ACI patients,and can thus help to predict the lipid-lowering efficacy of atorvastatin.