Gs蛋白227位氨基酸Gln/Leu基因变异对美托洛尔治疗充血性心力衰竭疗效的影响  

Effect of Gs Proteins227 Gln/Leu Gene Variation on Metoprolol Response in Congestive Heart Failure Patient

作　　者：魏朝晖 李宝群[2] 

机构地区：[1]河北省承德市中医院药剂科,河北承德067000 [2]承德医学院,河北承德067000

出　　处：《河北医学》2015年第11期1780-1782,共3页Hebei Medicine

基　　金：河北省卫生厅科研项目;(编号:NO.20110544)

摘　　要：目的：探讨Gs蛋白基因变异对美托洛尔治疗充血性心力衰竭临床疗效的影响。方法：64例心功能为Ⅱ-Ⅳ级的充血性心力衰竭患者（以美国纽约心脏病学会（NYHA）分级）应用限制性片段长度多态性方法进行基因分型后采取美托洛尔以12.5mg/d开始,每1-2周递增6.25mg共计一年,最大剂量为50mg/d。以左室射血分数（LVEF）的变化为指标,分析Gln/Leu基因多态性对美托洛尔临床疗效的影响。结果：美托洛尔治疗12月后,患者心功能分级与LVEF均明显改善（P〈0.05）。美托洛尔治疗6月和12月后,变异型患者LVEF的改善程度（P〈0.05）和心功能分级变化（P〈0.05）更为显著。结论：Gs蛋白α亚基第227位遗传多态性与美托洛尔疗效相关,基因变异携带者疗效更为显著。Objective： To study the association between Gs proteins（GNAS1 ） 227 Gln/Leu gene polymorphism and the effect of metoprolol on patients with congestive heart failure. Method： 64 patients with congestive heart failure were recruited for the study and the genotypes of GNAS1 227 Gln/Leu were determined by PCR-RFLP assay. Metoprolol was used in these patients, the initial dosage was 12.5mg once daily and increased 6.25mg every 1-2 weeks gradually to objective dosage of 50mg/day,Total follow-up was 12 months. The two primary outcome measures were New York Heart Association functional class and left ventricular ejection fraction. Result： Mter 6 and 12 months, metoprolol increased LVEF and changed NYHA class distribution more favorably for homozygous CC patients verus those with carriers T gene （ P〈0.01 ）.Conclusion： Gs proteins 227 Gln/Leu genetic polymorphism is related with therapeutic efficacy of metoprolol and the variant gene with a greater response in chronic congestive heart failure patients.

关 键 词：Gs蛋白α亚基 遗传多态性 美托洛尔 充血性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]