基于ABCB1(2677T>G)基因多态性指导阿托伐他汀与瑞舒伐他汀个体化用药的临床研究

Clinical study on individualized medication of atorvastatin and rosuvastatin based on ABCB1(2677T>G)gene polymorphism

目的研究是否采纳基于ABCB1(2677T>G)基因多态性所给出的个体化用药建议对患者调脂疗效的影响。方法回顾性选取2020年12月—2022年12月河南理工大学第一附属医院住院高脂血症患者85例作为研究对象,患者均经过阿托伐他汀或瑞舒伐他汀连续治疗4周,采用荧光原位杂交法测定ABCB1(2677T>G)基因多态性。按照是否采纳基于ABCB1(2677T>G)基因多态性所给出的个体化用药建议将85例患者分为采纳建议组和未采纳建议组,采纳建议组中TT、GT型患者均服用瑞舒伐他汀,GG型患者均服用阿托伐他汀;未采纳建议组中TT、GT型患者均服用阿托伐他汀,GG型患者均服用瑞舒伐他汀。比较两组患者治疗前后的血脂变化率,观察是否采纳基于ABCB1(2677T>G)基因多态性所给出的个体化用药建议对患者调降脂治疗的影响。结果85例患者中ABCB1(2677T>G)基因频率分别为GG(25例)29.41%、GT(33例)38.82%、TT(27例)31.77%,ABCB1(2677T>G)基因型分布符合Hardy-Weinberg遗传平衡。治疗前,采纳建议组与未采纳建议组患者的总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)没有显著差异。治疗后,两组患者的TC、LDL-C变化率有极显著差异(P<0.001),而HDL-C变化率差异无统计学意义(P>0.05)。TT型患者治疗后的HDL-C变化率有显著差异(P<0.05);GT型患者治疗后,TC、HDL-C变化率均有显著差异(P<0.05),LDL-C变化率差异具有显著统计学意义(P<0.01);GG型患者治疗后,TC变化率有显著差异(P<0.05),LDL-C水平变化率的差异具有显著统计学意义(P<0.01),但HDL-C水平变化率的差异不具有统计学意义(P>0.05)。结论采纳基于ABCB1(2677T>G)基因多态性所给出的个体化用药建议的患者,其在降低TC、LDL-C水平方面的效果明显优于未采纳建议的患者。

Objective To study the effect of individualized medication advice based on ABCB1(2677T>G)gene polymorphism on lipid-lowering efficacy.Methods A retrospective study was conducted.A total of 85 patients with hyperlipidemia hospitalized in the First Affiliated Hospital of Henan Polytechnic University from December 2020 to December 2022 were selected as subjects.All patients were treated with atorvastatin or rosuvastatin for four weeks.The ABCB1(2677T>G)gene polymorphism was detected by fluorescence in situ hybridization.patients were divided into advice-accepting group and advice-not-accepting group according to whether they accepted the individualized medication advice given based on ABCB1(2677T>G)gene polymorphism.In the adviceaccepting group,both TT and GT type patients took rosuvastatin,while GG type patients took atorvastatin.TT and GT type patients in the advice-not-accepting group all took atorvastatin,while GG type patients took rosuvastatin.Effect of individualized medication advice based on ABCB1(2677T>G)gene polymorphism on lipid-lowering efficacy was studied,the change rate of blood lipid between the two groups before and after treatment were compared.Results ABCB1(2677T>G)gene frequency in 85 patients were GG(25 cases)29.41%,GT(33 cases)38.82%,TT(27 cases)31.77%,and the ABCB1(2677T>G)genotype conformed to Hardy-Weinberg genetic balance.Before treatment,there was no significant difference in TC,HDL-C and LDL-C between the two groups.After treatment,there were significant differences in TC and LDL-C between the two groups(P<0.001),but there was no significant difference in HDL-C(P>0.05).It was found that the change rate of HDL-C in patients with ABCB12677TT genotype was significantly different(P<0.05).The change rates of TC,HDL-C and LDL-C in patients with ABCB12677GT genotype were significantly different(P<0.05,0.01).The change rates of TC and LDL-C in patients with ABCB12677GG genotype were significantly different(P<0.05,0.01).But the change rate of HDL-C was not significantly different(P>0.05).Conclusion Patients who accepted individualized medication advice based on ABCB1(2677T>G)gene polymorphism had significantly better effects in reducing TC and LDL-C levels than those who did not.