不同三磷酸腺苷结合盒转运体B1 G2677T基因型急性脑梗死患者应用阿托伐他汀的降脂疗效  

Lipid-lowering effect of atorvastatin on patients with acute cerebral infarction with different genotypes of ATP-binding cassette subfamily B member 1 G2677T

作　　者：徐炳欣 李青华 田英娜 赵艳 许自强 Xu Bingxin;Li Qinghua;Tian Yingna;Zhao Yan;Xu Ziqiang(Department of Pharmacy,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China;Department of Neurology,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China)

机构地区：[1]河南科技大学附属许昌市中心医院药学部,许昌461000 [2]河南科技大学附属许昌市中心医院神经内科,许昌461000

出　　处：《中华行为医学与脑科学杂志》2023年第4期308-315,共8页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：2018年中央引导地方科技发展专项资金支持项目(豫财科[2018]106号);河南省医学科技攻关计划项目(LHGJ20191386);河南省医学科技攻关计划项目(LHGJ20221024)。

摘　　要：目的观察不同三磷酸腺苷结合盒转运体B1(ATP-binding cassette subfamily B member 1,ABCB1)G2677T基因型急性脑梗死患者应用阿托伐他汀的降脂疗效,为急性脑梗死患者个体化应用阿托伐他汀提供临床研究证据。方法自2021年3—12月连续纳入许昌市中心医院神经内科收治的急性脑梗死患者131例,采用荧光染色原位杂交技术检测患者ABCB1 G2677T(rs2032582)基因多态性,并根据检测结果将患者分为GG、GT和TT共3组。3组患者均给予阿托伐他汀(20 mg/d)降脂治疗,记录治疗前及治疗2个月后3组患者血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)水平并分析其变化,记录3组患者药物不良反应发生情况。以血清LDL-C水平<1.8 mmol/L为降脂治疗有效,二元Logistic回归分析探索阿托伐他汀降脂疗效的影响因素。统计软件为SPSS 25.0。结果GG、GT和TT 3组分别有50例(38.17%)、49例(37.40%)和32例(24.43%)患者。治疗后GG、GT、TT 3组患者血清TC水平分别为(3.47±0.70)mmol/L、(3.59±1.09)mmol/L和(3.48±1.02)mmol/L,低于治疗前的(4.27±0.99)mmol/L、(4.02±0.98)mmol/L和(4.03±1.31)mmol/L,均差异有统计学意义(t=7.652,3.092,5.593,均P<0.01)。治疗后GG、GT、TT 3组患者血清LDL-C水平分别为(1.89±0.53)mmol/L、(2.07±0.92)mmol/L和(1.96±0.79)mmol/L,低于治疗前的(2.87±0.92)mmol/L、(2.56±0.89)mmol/L和(2.55±1.11)mmol/L,均差异有统计学意义(t=9.896,4.055,5.980,均P<0.001)。治疗前后GG组血清LDL-C水平差值为(-0.97±0.69)mmol/L,GT组和TT组分别为(-0.50±0.86)mmol/L和(-0.59±0.56)mmol/L,3组治疗前后血清LDL-C水平差值之间差异有统计学意义(F=5.614,P=0.005)。3组患者治疗前后TC、TG、HDL-C差值差异无统计学意义(F=2.783,0.490,1.677,均P>0.05)。二元Logistic回归分析显示,ABCB1 G2677T基因类型和熬夜是阿托伐他汀降脂治疗的独立影响因素,其中ABCB1 G2677T基因GT型患者降脂有效的概率�Objective To observe the lipid-lowering effect of atorvastatin on patients with acute cerebral infarction with different ATP-binding cassette subfamily B member 1(ABCB1)genotypes,and thus to provide clinical research evidence for individual application of atorvastatin in patients with acute cerebral infarction.Methods From March 2021 to December 2021,131 patients with acute cerebral infarction admitted to the Department of Neurology of Xuchang Central Hospital were included.The ABCB1 G2677T gene polymorphism rs2032582 of patients was detected by fluorescence staining in situ hybridization.Based on the detection results,patients were divided into GG group,GT group and TT group.All patients were given atorvastatin(20 mg/d)for lipid-lowering treatment.The levels of low density lipoprotein cholesterol(HDL-C),high density lipoprotein cholesterol(HDL-C),total cholesterol(TC)and triglyceride(TG)in serum of patients in the three groups before and 2 months after treatment were recorded and analyzed.The adverse drug reactions in the three groups were recorded.When the serum LDL-C level was less than 1.8 mmol/L,it was considered that the lipid-lowering treatment was effective.The binary Logistic regression analysis was used to explore the influencing factors of atorvastatin lipid lowering therapy.The software of SPSS 25.0 was used for statistical analysis.Results There were 50(38.17%),49(37.40%)and 32(24.43%)patients in GG group,GT group and TT group,respectively.The serum TC levels of patients in GG group,GT group and TT group after treatment were(3.47±0.70)mmol/L,(3.59±1.09)mmol/L and(3.48±1.02)mmol/L,respectively,which were lower than those before treatment((4.27±0.99)mmol/L,(4.02±0.98)mmol/L and(4.03±1.31)mmol/L),all of which were statistically significant(t=7.652,3.092,5.593,all P<0.01).The serum LDL-C levels in GG group,GT group and TT group after treatment were(1.89±0.53)mmol/L,(2.07±0.92)mmol/L and(1.96±0.79)mmol/L,respectively,which were lower than those before treatment((2.87±0.92)mmol/L,(2.56±0.89)mmol

关 键 词：急性脑梗死 基因多态性 三磷酸腺苷结合盒转运体B1 G2677T基因 阿托伐他汀 降脂治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]