老年心力衰竭患者ABCB1基因多态性对比索洛尔血药浓度及疗效的相关性研究

Relationship of ABCB1gene polymorphisms with serum level and therapeutic effect of bisoprolol in elderly heart failure patients

目的探讨ABCB1基因C3435T多态性对老年心力衰竭患者体内比索洛尔血药浓度的影响及其与比索洛尔治疗效果的相关性。方法选择2018年1月~2019年6月滨州医学院烟台附属医院重症医学科收治的老年心力衰竭患者132例,根据C3435T基因型分为CC组49例,CT组64例,TT组19例。3组均口服比索洛尔5mg/d,比较1周后血药浓度及1个月后心功能。结果TT组血药浓度明显低于CC组和CT组[(25.33±10.43)μg/L vs(42.35±15.29)μg/L、(37.38±13.92)μg/L,P<0.05]。CC组和CT组心功能改善情况明显优于TT组,差异有统计学意义(P<0.05)。CC组和CT组治疗后心功能Ⅰ~Ⅱ级比例明显高于TT组(87.8%、84.4%vs 57.9%,P<0.05)。3组治疗前心功能Ⅰ~Ⅱ级比例比较,差异无统计学意义(28.6%vs 29.7%%vs 26.3%,P>0.05)。结论ABCB1基因C3435TCC型和CT型心力衰竭患者对比索洛尔更为敏感,患者心功能改善更为明显。

Objective To study the effect of ABCB1gene C3435Tpolymorphism on serum bisoprolol level in elderly heart failure(HF)patients and its relationship with the therapeutic effect of bisoprolol.Methods One hundred and thirty-two elderly HF patients admitted to our hospital from January 2018to June 2019were divided into CC group(n=49),CT group(n=64)and TT group(n=19)according to their C3435Tgenotype.The patients in 3groups were given oral bisoprolol(5mg/d).Their serum bisoprolol level was measured after 1week of treatment and their cardic function was assayed after 1month of treatment.Results The serum bisoprolol level was significantly lower in TT group than in CC group and CT group(25.33±10.43μg/L vs 42.35±15.29μg/L,37.38±13.92μg/L,P<0.05).The cardiac function was significantly better in CC group and CT group than in TT group(P<0.05).The rate of NYHAⅠandⅡwas significantly higher in CC group and CT group than in TT group after treatment(87.8%,84.4%vs 57.9%,P<0.05).No significant difference was detected in the ratio of NYHAⅠandⅡin 3groups before treatment(28.6%vs 29.7%%vs 26.3%,P>0.05).Conclusion Bisoprolol can effectively treat HF with CC and CT genotype of ABCB1gene C3435Tand improve their cardiac function.