职业紧张性高血压患者β_2肾上腺素能受体基因单核苷酸多态性与美托洛尔治疗效果的相关性研究  

Association of Single Nucleotide Polymorphisms of β_2 Adrenergic Receptor Gene with Metoprolol in Occupational Stress Hypertensive

作　　者：洪雷[1] 刘耿科 杨普查 HONG Lei;LIU Gengke;YANG Pucha(Longgang Central Hospital,Shenzhen 518116,China)

机构地区：[1]深圳市龙岗中心医院,广东深圳518116

出　　处：《中外医学研究》2018年第13期1-4,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：深圳市龙岗区科技发展资金医疗卫生项目(项目编号:YLWS20150514115746187)

摘　　要：目的:观察职业紧张对1级高血压患者β_2受体(β_2 AR)基因单核苷酸多态性分布的影响,探讨美托洛尔的治疗效果。方法:选取2015年1月-2017年1月笔者所在医院初诊的1级高血压患者100例,进行β_2 AR单核苷酸多态性(SNP)分型,由职业紧张量表(OSI-R)评估患者职业紧张程度,将患者得分按三分位法进行分类,第一个三分位数(154.92分)以下者33例为非职业紧张组,设为A组,第二个三分位数(170.08分)以上者31例为职业紧张组,设为B组,均予美托洛尔47.5 mg/d,并分别在治疗前和治疗4周后检测患者24 h动态血压、24 h动态心电图。结果:两组患者一般特征、SNP分布和治疗前血压比较差异均无统计学意义(P>0.05);治疗后B组收缩压降幅为(9.48±3.32)mm Hg,显著大于A组的(7.73±3.02)mm Hg(P<0.05);治疗前两组患者中GG型的收缩压、舒张压均高于同组的AA型、AG型(P<0.05),治疗后A组AG型收缩压降幅为(7.83±3.67)mm Hg、舒张压降幅为(7.83±3.09)mm Hg,B组AG型收缩压降幅(9.70±2.82)mm Hg、舒张压降幅为(8.05±2.82)mm Hg,B组AG型收缩压、舒张压平均降幅均显著高于A组AG型(P<0.05),而AA型、GG型的收缩压、舒张压平均降幅A、B组间比较差异均无统计学意义(P>0.05);美托洛尔可显著降低两组患者心率,治疗后B组心率降幅为(11.89±5.77)次/min,高于A组的(8.30±4.10)次/min(P<0.05),治疗后B组AG型心率降幅为(11.6±5.94)次/min,大于A组AG型的(7.72±3.54)次/min(P<0.05)。结论:职业紧张不影响β_2 AR的A46G的SNP和血压水平,不同SNP的心率及血压不同,对美托洛尔的敏感性也不同。Objective：To investigate the SNP of β2 AR in grade 1 hypertensive patients with or without occupational stress,and to explore the therapeutic effect of Metoprolol.Method：From January 2015 to January,100 patients with grade 1 hypertension who were newly diagnosed in author＇s hospital were recruited for β2 AR single nucleotide polymorphism（SNP） typing.Occupational stress scale（OSI-R） was used to assess the degree of occupational stress in patients,and the patient score was divided into three points. In the first three-digits（154.92 points）,33 patients were classified as non-professional stress group,and were assigned group A,31 patients in the second three-digits（170.08 points） were occupational stress group,and were assigned group B.Metoprolol was administered at 47.5 mg/d. 24 h ambulatory blood pressure and 24 h dynamic electrocardiogram were measured before and after treatment for 4 weeks respectively.Result：There was no significant difference in general characteristics,SNP and pre-treatment blood pressure between the two groups（P〈0.05）.After treatment,SBP in group B decreased by（9.48±3.32）mm Hg which was significantly higher than（7.73±3.02）mm Hg in group A（P〈0.05）.Before treatment,SBP and DBP of the GG type were higher than those of the same group AA and AG（P〈0.05）.After treatment,the AG type SBP decreased by（7.83±3.67）mm Hg and DBP decreased by（7.83±3.09）mm Hg in group A,the AG type SBP decreased by（9.70±2.82）mm Hg and DBP decreased by（8.05±2.82）mm Hg in group B.The decrease in SBP and DBP in group B was significantly higher than that in group A（P〈0.05）,while the mean reductions in SBP and DBP in groups AA and GG were not statistically significant between groups A and B（P〈0.05）.Metoprolol significantly reduced the heart rate in both groups.After treatment,heart rate reduction in group B was（11.89±5.77）beats/min,which was higher than（8.30±4.10）beats/min in group A（P〈0.05）.After treatment, the rate of decline of

关 键 词：职业紧张 高血压 Β2肾上腺素能受体 单核苷酸多态性 美托洛尔 

分 类 号：R544.1[医药卫生—心血管疾病]