β1受体A145G和G1165C多态性对比索洛尔治疗高血压疗效的影响  

The influence of different β1-adreneric receptor genotypes( A145G and G1165C) on antihypertensive effect of bisoprolol

作　　者：周丽英[1] 王宏伟[2] 郝志敏[2] 

机构地区：[1]上海交通大学附属第六人民医院南院老年病科,上海201400 [2]上海交通大学附属第六人民医院南院心血管内科,上海201400

出　　处：《临床和实验医学杂志》2016年第13期1285-1288,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨比索洛尔对高血压患者的疗效及β1肾上腺素受体A145G与G1165C多态性的关系,以期能从基因水平指导高血压病的治疗。方法收集300例轻中度高血压患者(研究组),另选同期体检健康人群300例(对照组),采用PCR-RFLP方法从白细胞中提取DNA,进行β1肾上腺素受体A145G突变(Ser49Gly)及G1165C突变(Gly389Arg)基因分型。从所有患者中选择49SS/389AA、49SG/389AA、49SG/389GA与49SS/389GA个体采用双盲法进行前瞻性临床实验。临床给药方案为比索洛尔2.5 mg/d一次口服,治疗疗程为4周。比较两组间及组内心率及血压水平。结果对于位点389和位点49,4种基因型患者静息心率、舒张压、收缩压、平均动脉压差异有显著性(P<0.05),基因型为49SG/389AA的患者静息心率、舒张压、收缩压、平均动脉压较其它三组明显增加,差异有显著性(P<0.05)。49SS/389GA基因型患者经比索洛尔治疗后静息心率、舒张压、收缩压、平均动脉压降低幅度比49SS/389AA、49SG/389AA、49SG/389GA基因型患者显著,差异具有统计学意义(P<0.05)。结论高血压患者中基因型为49SS/389GA的患者应用索洛尔产生的心血管效应和治疗效果更为显著。Objective To explore two common SNPs of β1 adrenergic receptor（Gly389Arg and Ser49Gly）on patients with essential hy-pertension（EH）and to study the association between these two SNPs of β1 - AR（Gly389Arg and Ser49Gly）and the efficacy of bisoprolol on es-sential hypertension,and to raise the level of clinical therapy to individuation and optimization by conducting the EH treatment to the gene level. Methods A total of 300 patients with mild or moderate essential hypertension were enrolled in the study group. Their WBC were used to extract DNA with PCR - RFLP. The polymorphism of β1 adrenergic receptor（Gly389Arg and Ser49Gly）had been analyzed. The individuals with their genotype of 49SS / 389AA,49SG/ 389AA,49SG/ 389GA and 49SS / 389GA were chosen to join the prospective clinical trial according to double blind rule. The dosage regimen of bisoprolol was 2. 5 mg qd,and the course of treatment was 4 weeks. Their HR and BP were measured every week. The data of measurement were compared. Results As to condon 389 and 49,the resting HR,SBP,DBP and MBP of patients with 4 geno-types were different after administration of bisoprolol for 4 weeks（ P 〈 0. 05）. The resting HR,SBP,DBP and MBP of patients with 49SG/389AA were higher than those of other groups（ P 〈 0. 05）. The above indexs of patients with 49SS/ 389GA were lower than those of other groups （ P 〈 0. 05）. Conclusion Patients with 49SS/ 389GA genotype were associated with better response to bisoprolol and they may gain more bene-fits from bisoprolol for treatment of essential hypertension.

关 键 词：原发性高血压 Β1肾上腺素受体 比索洛尔 基因多态性 

分 类 号：R544.1[医药卫生—心血管疾病]