药物基因多态性与冠心病预后的相关性研究

Correlation between gene polymorphisms of drugs and prognosis of coronary heart disease

目的探讨冠心病二级预防药物的基因多态性与冠心病患者长期预后的相关性。方法回顾性纳入冠心病患者128例,将其分为慢性冠脉综合征(CCS)组53例和急性冠脉综合征(ACS)组75例,根据生存结局再将其分为存活组116例和死亡组12例。通过电子病历系统查询所有患者的一般资料、临床资料及药物基因分型并分组进行比较。采用Cox单因素回归分析和Cox生存分析评估影响冠心病患者全因死亡的相关因素。结果死亡组患者年龄高于存活组,Alb水平低于存活组(P<0.05)。Cox单因素回归分析结果显示,年龄、出院心率、超敏C反应蛋白(hs-CRP)、糖化血红蛋白(HbA1c)均与冠心病患者全因死亡相关;Cox生存分析结果显示,hs-CRP、HbA1c均与冠心病患者全因死亡相关(P<0.05)。ACS组患者入院后行冠脉再灌注治疗比例及HbA1c水平均高于CCS组(P<0.05)。Cox单因素回归分析结果显示,出院心率、hs-CRP及HbA1c均与ACS患者全因死亡相关;Cox生存分析结果显示,HbA1c与ACS患者全因死亡相关(P<0.05)。结论对于良好管理的冠心病患者,未能观察到冠心病二级预防药物的基因多态性其长期预后的相关性,炎症和血糖管理在冠心病中的作用值得深入研究。

Objective To explore the correlation between gene polymorphism of secondary prevention drugs of coronary heart disease and long-term prognosis of patients with coronary heart disease.Methods A total of 128 patients with coronary heart disease were retrospectively selected and divided into chronic coronary syndrome(CCS) group(53 cases) and acute coronary syndrome(ACS) group(75 cases).According to the survival outcome, they were divided into survival group(116 cases) and death group(12 cases).General data, clinical data and drug genotyping of patients were queried by electronic medical record system and grouped for comparison.Cox univariate regression analysis and cox survival analysis were used to evaluate the factors affecting all-cause death in patients with coronary heart disease.ResultsAge of patients in death group was higher than that in survival group, and Alb level was lower than that in survival group(P<0.05).Cox univariate regression analysis showed that age, discharge heart rate, high sensitive C-reactive protein(hs-CRP) and glycohemoglobin(HbA1c) were related with all-cause death in patients with coronary heart disease;cox survival analysis showed that hs-CRP and HbA1c were related with all-cause death in patients with coronary heart disease(P<0.05).Proportion of patients receiving coronary reperfusion therapy and HbA1c level after admission in ACS group were higher than those in CCS group(P<0.05).Cox univariate regression analysis showed that discharge heart rate, hs-CRP and HbA1c were related with all-cause death in ACS patients;cox survival analysis showed that HbA1c was related with all-cause death in patients with ACS(P<0.05).Conclusion To well-managed patients with coronary heart disease, correlation between gene polymorphism of secondary prevention drugs of coronary heart disease and long-term prognosis of patients with coronary heart disease is not observed.Role of inflammation and blood glucose management in coronary heart disease deserves further study.