Gs蛋白α亚基T393C多态性对卡维地洛治疗充血性心力衰竭疗效的影响  

Effects of Gs proteins α subunit T393C genetic polymorphism on carvedlol response in congestive heart failure patients

作　　者：李宝群[1] 李海艳[1] 孙立贤[2] 王瑞婷[1] 

机构地区：[1]承德医学院药理研究室,067000 [2]承德医学院附属医院心内科,067000

出　　处：《实用医学杂志》2014年第21期3431-3433,共3页The Journal of Practical Medicine

基　　金：河北省卫生厅项目(编号:20110544)

摘　　要：目的：探讨Gs蛋白α亚基T393C多态性对卡维地洛治疗充血性心力衰竭临床疗效的影响。方法：临床收集美国纽约心脏病学会（NYHA）心功能分级为Ⅱ~Ⅳ级的64例充血性心力衰竭患者,采取PCR-RFLP方法进行Gs蛋白α亚基多态性分型后均在常规治疗基础上加卡维地洛治疗。卡维地洛以12.5mg/d开始,每1~2周递增6.25 mg,连续使用12个月,最大剂量为50 mg/d。以左室射血分数（LVEF）的变化和心功能改善的程度为指标,分析Gs蛋白基因多态性对卡维地洛治疗心力衰竭临床疗效的影响。结果：卡维地洛治疗12个月后,NYHA心功能分级与LVEF在充血性心力衰竭患者中均明显改善（P〈0.05）。卡维地洛治疗6个月和12个月后,突变型患者心功能改善情况（P〈0.01）和LVEF的增加程度（P〈0.01）更为显著。结论：Gs蛋白α亚基第393位遗传多态性与充血性心力衰竭疗效相关,393位突变纯合子和杂合子心功能改善和LVEF的提高更为显著。Objective To find out the distribution of the subunit of Gs proteins （GNAS1） T393C polymorphism genetic in congestive heart failure patients and to investigate the effects of genetic polymorphisms on the therapeutic efficacy of carvedlol. Methods Genotype of 65 patients with congestive heart failure （heart function was ranked Ⅱ~Ⅳ level by NYHA） underwent PCR-RFLP for GNAS1 polymorphism genetic analysis, and then were treated with carvedlol. The initial dosage of carvedlol was 12.5 mg once daily in patients , and increased by 6.25 mg every 1 ~ 2 weeks for 12 months to a maximum dosage within 50 mg/d. Degree of LVEF changes and heart function improvement was adopted as measuring index , effect of Gs proteins α subunit T393C genetic polymorphism on carvedlol response in congestive heart failure patients was analyzed. Results After carvedlol treatment for 12 months , NYHA class distribution and LVEF in congestive heart failure patients improved significantly （P 〈 0.05）. After carvedlol treatment for 6 months and 12 months mutation symptoms patients′ heart function improved significantly （P 〈 0.05） and LVEF increased significantly （P 〈 0.01）. Conclusions GNAS1 T393C genetic polymorphism can influence the therapeutic efficacy of carvedlol in chronic congestive heart failure patients. 393 homozygous mutant and mutated symptoms patients′ heart improved more obviously and their LVEF improved more significantly.

关 键 词：Gs蛋白α亚基 遗传多态性 卡维地洛 充血性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]