沈阳地区汉族急性冠状动脉综合征合并糖尿病患者SLCO1B1和ApoE基因多态性分布

Distribution and correlation analysis of SLCO1B1 and ApoE gene polymorphisms in Han Chinese patients with acute coronary syndrome combined with diabetes mellitus in Shenyang city

目的:探讨沈阳地区汉族急性冠状动脉综合征(ACS)合并糖尿病患者SLCO1B1和ApoE基因多态性分布情况,以指导临床用药,平衡他汀类药物应用的有效性与安全性。方法:随机选取2016年9月至2018年1月沈阳医学院附属第二医院入住的ACS合并糖尿病患者203例,应用PCR-荧光探针法对受检血样进行DNA的提取及PCR的扩增,从而读取SLCO1B1和ApoE的基因。结果:本研究血液样本中共检测到7种SLCO1B1基因型,分别为SLCO1B1基因型*1a/*1b型(34.48%)、*1b/*1b型(30.54%)、*1b/*15型(15.76%)、*1a/*1a型(11.33%)、*1a/*15型(5.42%)、*15/*15型(1.97%)、*1a/*5型(0.49%),未检测到*5/*5型和*5/*15型;5种ApoE基因型,分别为ApoE基因型E3/E3型(66.00%)、 E3/E4型(20.20%)、E2/E3型(10.34%)、E4/E4型(1.97%)、E2/E4型(1.48%),未检测到E2/E2型。不同SLCO1B1和ApoE基因表型患者在性别、年龄分布,以及血脂水平上差异无统计学意义。结论:沈阳地区汉族ACS合并糖尿病患者SLCO1B1基因以耐受较高型(*1a/*1a、*1a/*1b、*1b/*1b)为主,应用他汀类药物肌溶解、肌病风险较低;ApoE基因以一般型(E2/E4、E3/E3)为主,降脂疗效较好,但仍需警惕患老年相关疾病的风险。

Objective:To investigate the distribution of SLCO1 B1 and ApoE gene polymorphisms in Han Chinese patients with acute coronary syndrome(ACS) combined with diabetes mellitus in Shenyang area, in order to guide clinical medication. Methods:A total of 203 patients with ACS combined with diabetes mellitus treated in the Second Hospital Affiliated to Shenyang Medical College from Sep 2016 to Jan 2018 were enrolled. Genomic DNA was extracted from the blood sample, and the gene polymorphisms of SLCO1 B1 and ApoE were genotyped by PCR-fluorescence probe method. Results: Seven genotypes of SLCO1 B1 were detected. They were*1 a/*1 b(34.48%),*1 b/*1 b(30.54%),*1 b/*15(15.76%),*1 a/*1 a(11.33%),*1 a/*15(5.42%),*15/*15(1.97%)and*la/*5(0.49%). SLCO1 B1*5/*5 and SLCO1 B1*5/*15 were not detected. Five genotypes of ApoE were detected. They were E3/E3(66.00%), E3/E4(20.20%), E2/E3(10.34%), E4/E4(1.97%) and E2/E4(1.48%). Apo E2/E2 was not detected. There was no significant difference in SLCO1 B1 and ApoE genotypes in sex, age distribution and blood lipid level. Conclusions: SLCO1 B1 genotypes in Han patients with ACS combined with diabetes mellitus in Shenyang area are mainly of the high-endurance types(*1 a/*1 a,*1 a/*1 b,*1 b/*1 b), and the application of statins has a lower risk of myolysis and myopathy. The ApoE genotypes are mainly of the general types(E2/E4, E3/E3), which has a good effect on lipid reduction. However, the risk of aging-related diseases still needs to be guarded.