538例高血压患者的药物基因多态性与精准用药分析

Analysis of drug gene polymorphisms and precise drug use in 538 patients with hypertension

目的分析高血压患者的药物基因多态性,探讨高血压药物基因检测的临床应用价值,为精准用药提供依据。方法运用描述性统计分析方法,对重庆市永川区中医院2019年5月~2023年1月的538例高血压患者的抗高血压药物相关基因检测结果进行统计分析。结果538例高血压患者中,药物代谢酶基因多态性位点,CYP3A5*3基因突变频率最高,为67.66%,CYP2C9*3基因突变的频率最低,为4.74%;药物作用靶点基因多态性位点,ADRB1(c.1165 G>C)基因突变的频率最高,为72.96%,AGTR1(c.1166 A>C)基因突变的频率最低,为5.39%;大部分对β受体阻滞剂和钙通道拮抗剂(CCB)的反应比较敏感,对血管紧张素转化酶抑制剂(ACEI)和血管紧张素Ⅱ受体拮抗剂(ARB)的反应属正常水平。结论高血压患者对不同降压药物的反应可能不同,其CYP2C9*3和ACE(I/D)基因多态性分布与正常人群也可能存在差异,临床在选择此类药物进行降压治疗前可以进行药物基因检测,以指导临床精准用药。

Objective To analyze the polymorphism of drug genes in patients with hypertension,and explore the clinical application value of gene detection of hypertension drugs,so as to provide evidence for accurate medication.Methods Using descriptive statistical analysis methods,the results of anti hypertensive drug related gene testing in 538 patients with hypertension from May 2019 to January 2023 in Chongqing Yongchuan Hospital of Traditional Chinese Medicine were statistically analyzed.Results In 538 patients with hypertension,the frequency of CYP3A5*3 gene mutations was the highest(67.66%),while the frequency of CYP2C9*3 gene mutations was the lowest(4.74%)in the drug metabolizing enzyme genes;The frequency of mutations in the ADRB1(c.1165 G>C)gene is the highest at 72.96%,while the frequency of mutations in the AGTR1(c.1166 A>C)gene is the lowest at 5.39%in the drug target genes;Most are relatively sensitive toβreceptor blockers and calcium channel blockers(CCB),and their responses to angiotensin converting enzyme inhibitors(ACEI)and angiotensinⅡreceptor antagonists(ARB)are at normal levels.Conclusion Hypertensive patients may have different reactions to different antihypertensive drugs,and their CYP2C9*3 and ACE(I/D)gene polymorphisms may also differ from those of the normal population.Before selecting such drugs for antihypertensive treatment,drug genetic testing can be conducted to guide clinical precise medication.