高血压基因导向个体化用药在老年高血压患者中的应用效果

Application effect of hypertension gene-oriented individualized medication in elderly patients with hypertension

目的:分析老年高血压人群抗高血压药物的预期疗效和预期不良反应发生率,比较基因指导用药与传统降压治疗的疗效差异,探讨其临床应用价值。方法:选择2021年3月至2022年2月,在我院心内科确诊的241例老年高血压患者,按随机数字表法将患者分为基因组121例,对照组120例。对基因组的121例患者行抗高血压药物基因检测,分析基因位点的分布情况、统计抗高血压药物的预期疗效和预期不良反应发生率,并根据其检测结果给予基因导向个体化用药;对照组则给予传统降压治疗,观察干预3个月后两组间的疗效差异。结果:基因组患者对钙通道阻滞剂预期疗效最佳,患者频率为60.0%;对β受体阻滞剂预期疗效居第二位,患者频率为54.2%;对β受体阻滞剂的预期不良反应较高,患者频率为16.7%。经过3个月的干预治疗,基因组相比对照组在收缩压、平均动脉压、日平均口服降压药费用方面均明显改善,且具有更好的治疗依从性,差异有统计学意义(P<0.01)。结论:老年高血压人群的药物预期疗效和预期不良反应发生率存在显著的个体差异,高血压基因导向个体化用药对老年患者降压具有良好的指导作用。

Objective:To analyze the expected efficacy and the expected incidence of adverse reactions of antihypertensive drugs in elderly hypertensive population,to compare the efficacy difference between gene-oriented medication and traditional antihypertensive therapy,and to explore its clinical applications.Methods:241 elderly patients with hypertension who were confirmed in the Department of Cardiology of our hospital from March 2021 to February 2022 were selected,and divided into gene group(121 cases)and control group(120 cases)according to random number table method.121 patients in gene group underwent gene detection related to antihypertensive drug genes,the distribution of gene loci was analyzed,the expected efficacy and the expected incidence of adverse reactions of antihypertensive drugs were counted,and gene-oriented individualized drugs were given according to the detection results;the control group was given traditional antihypertensive treatment,and the efficacy difference between the two groups was observed after intervention for 3 months.Results:Patients in gene group had the best expected efficacy on calcium channel blockers,and the frequency of patients was 60.00%.The expected efficacy on beta blockers ranked second,and the frequency of patients was 54.17%.The expected adverse reactions to beta blockers were high,and the frequency of patients was 16.67%.After intervention treatment for 3 months,gene group showed significant improvement in systolic blood pressure,mean arterial pressure and daily average cost of oral antihypertensive drugs,and had better treatment compliance compared with the control group,and the difference was statistically significant(P<0.01).Conclusions:There are significant individual differences in the expected efficacy and the incidence of adverse drug reactions in elderly patients with hypertension.Gene-oriented individualized medication of hypertension has a good guiding role in lowering blood pressure in elderly patients.