脑梗死患者基因多态性检测指导他汀药物的应用疗效与安全性分析  

Analysis of the efficacy and safety of statins in patients with cerebral infarction guided by gene polymorphism detection

作　　者：范玉兰[1] 王勇[1] FAN Yulan;WANG Yong(Jilin People's Hospital,Jilin,Jilin,132001,China)

机构地区：[1]吉林市人民医院,吉林吉林132001

出　　处：《当代医学》2022年第23期168-170,共3页Contemporary Medicine

摘　　要：目的探讨脑梗死患者基因多态性检测指导他汀药物的应用疗效与安全性。方法选取2018年1月至2021年1月本院收治的205例急性脑梗死患者作为研究对象,均行SLCO1B1基因多态性、ApoE基因多态性检测,其中他汀疗效正常的ApoE基因E3型同时具有正常肌病分险SLCO1B1基因型137例作为观察组,其他基因型68例作为对照组。两组均给予阿托伐他汀钙片治疗,观察组给予40 mg,1个月后调整为20 mg,对照组给予20 mg,比较两组临床疗效、低密度脂蛋白胆固醇(LDL-C)达标情况、肝功转氨酶、肌酸激酶水平。结果观察组治疗总有效率为96.35%,明显高于对照组的79.41%,差异有统计学意义(P<0.05)。治疗1、3、5个月,观察组LDL-C达标率均高于对照组,差异有统计学意义(P<0.05)。观察组治疗1、3、5个月及对照组治疗1个月肝功转氨酶、肌酸激酶水平均正常。对照组治疗3个月出现肝功转氨酶增高2例,治疗5个月出现肝功转氨酶增高3例,其中伴肌酸激酶增高2例。结论基因多态性检测指导他汀类药物应用个体化、精准、安全、经济,值得临床推广应用。Objective To explore the efficacy and safety of statins in patients with cerebral infarction guided by gene polymorphism detection.Methods 205 patients with acute cerebral infarction admitted to our hospital from January 2018 to January 2021 were selected as the study subjects,and all of them underwent SLCO1B1 gene polymorphism and ApoE gene polymorphism detection.Among them,137 patients with ApoE gene E3 with normal statin response and SLCO1B1 with normal myopathy risk were selected as the observation group,68 cases of other genotypes were used as control group.Both groups were given atorvastatin calcium tablets,the observation group was given 40 mg,which was adjusted to 20 mg after 1 month,and the control group was given 20 mg,.The clinical efficacy,low density lipoprotein cholesterol(LDL-C),liver function transaminase and creatine kinase levels were compared between the two groups.Results The total effective rate of the observation group was 96.35%,which was significantly higher than 79.41%of the control group,and the difference was statistically significant(P<0.05).After 1,3 and 5 months of treatment,the LDL-C compliance rate in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Liver function transaminase and creatine kinase levels were normal in observation group 1,3 and 5 months of treatment and control group 1 month of treatment.In the control group,liver transaminase increased in 2 cases at 3 months of treatment,liver transaminase increased in 3 cases at 5 months of treatment,and creatine kinase increased in 2 cases.Conclusion Gene polymorphism detection can guide the individual,accurate,safe and economical application of statins,which is worthy of clinical application.

关 键 词：急性脑梗死 基因多态性 他汀类药物 

分 类 号：R743.33[医药卫生—神经病学与精神病学]