ADRB2（rs1042713）基因多态性对抗胆碱能药物治疗难治性哮喘患儿疗效的影响  

Effects of ADRB2(rs1042713) Gene Polymorphism on Therapeutic Efficacy of Anticholinergic Drugs in the Treatment of Refractory Asthma Pediatric Patients

作　　者：任丹阳[1] 涂彩霞[1] 李惠英[1] 李云巍[1] 李明[2] 叶冬梅[2] 沈建玲 郭品[1] 李远丽 徐涛[4] 张泉[2] REN Danyang;TU Caixia;LI Huiying;LI Yunwei;LI Ming;YE Dongmei;SHEN Jianling;GUO Pin;LI Yuanli;XU Tao;ZHANG Quan(Dept.of Pharmacy,Children’s Hospital of Kunming Medical University,Kunming 650228,China;Dept.of Respiration,Children’s Hospital of Kunming Medical University,Kunming 650028,China;School of Pharmacy,Haiyuan College,Kunming Medical University,Kunming 650106,China;School of Pharmacy,Anhui Medical University,Hefei 230032,China)

机构地区：[1]昆明医科大学附属儿童医院药剂科,昆明650228 [2]昆明医科大学附属儿童医院呼吸科,昆明650228 [3]昆明医科大学海源学院药学院,昆明650106 [4]安徽医科大学药学院,合肥230032

出　　处：《中国药房》2019年第23期3265-3270,共6页China Pharmacy

基　　金：国家自然科学基金资助项目（No.81700522）;云南省卫生科技计划项目（No.2018NS0174）;昆明市卫生科技人才培养项目（No.2019-后备人选-32）

摘　　要：目的:研究ADRB2(rs1042713)基因多态性对抗胆碱能药物治疗难治性哮喘患儿疗效的影响。方法:选取2016年11月-2019年7月昆明市儿童医院门诊就诊的171例难治性哮喘患儿,统计其ADRB2(rs1042713)基因型分布及其抗胆碱能药物临床疗效[哮喘控制测试(C-ACT)评分、第1秒用力呼气量(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)、最大呼气中断流量(MMEF)],对不同基因型患儿使用抗胆碱能药物治疗的应答效果进行统计分析。结果:171例难治性哮喘患儿中,148例患儿给予抗胆碱能药物治疗,其中71例ADRB2(rs1042713)AA基因型患儿中50例有应答,77例ADRB2(rs1042713)GA基因型中36例有应答。统计结果分析表明,71例AA基因型患儿使用抗胆碱能药物治疗后C-ACT评分、FEV1、FVC、PEF、MMEF改善较大,与GA基因型患儿比较差异有统计学意义(P<0.05);AA基因型对抗胆碱能药物的应答率是GA基因型的2.71倍[OR=2.71,95%CI(1.38,5.34),P=0.005]。结论:ADRB2(rs1042713)基因多态性检测对抗胆碱能药物治疗难治性哮喘具有一定指导意义,其中AA基因型的应答较好。OBJECTIVE:To study the effects of ADRB2(rs1042713)gene polymorphism on therapeutic efficacy of anticholinergic drug in the treatment for refractory asthma pediatric patients.METHODS:171 children with refractory asthma were selected from outpatient department of Kunming Children’s Hospital during Nov.2016 to Jul.2019.The distribution of ADRB2(rs1042713)genotype,the clinical efficacy[asthma control test(C-ACT)score,FEV1,FVC,PEF,maximal mid-expiratory flow(MMEF)]of anticholinergic drug were analyzed statistically;the response of different genotypes to the use of anticholinergic drug were also analyzed statistically.RESULTS:148 of 171 refractory asthmatics pediatric patients were administered anticholinergic drug,among them 50 of the 71 AA genotype and 36 of the 77 GA genotype responded to anticholinergic drug treatment.Statistical analysis showed that 71 children with AA refractory asthma had improved C-ACT score,FEV1,FVC,PEF and MMEF,there was statistical significance,compared with GA genotype(P<0.05);the response rate of the AA genotype to anticholinergic drugs was2.71 times that of the GA genotype[OR=2.71,95%CI(1.38,5.34),P=0.005].CONCLUSIONS:The detection of ADRB2(rs1042713)gene polymorphism has some guiding significance in the treatment of refractory asthma with anticholinergic drugs,and the response of AA genotype is better.

关 键 词：难治性哮喘 ADRB2(rs1042713) 基因多态性 抗胆碱能药物 儿童 

分 类 号：Q343.12[生物学—遗传学] R256.12[医药卫生—中医内科学]