SLCO1B1和ApoE基因多态性检测与他汀类药物临床应用专家共识  

Expert consensus on detection of SLCO1B1 and ApoE gene polymorphisms and clinical application of statins

作　　者：中国中西医结合学会检验医学专业委员会 浙江省免疫学会临床免疫诊断专业委员会 浙江省药理学会治疗药物监测研究专业委员会 王建安[2] 杨曦明[3] 戴海斌[4] 陶志华[5] 杨明东 段秀枝[5] Laboratory Medicine Committee of Chinese Association of Integrated Medicine;Clinical Immunodiagnosis Professional Committee of Zhejiang Immunology Society;Therapeutic Drug Monitoring Research Professional Committee of Zhejiang Pharmacological Society;Wang Jianan;Yang Ximing;Dai Haibin

机构地区：[1]不详 [2]浙江大学医学院附属第二医院心血管内科 [3]北京中医药大学东直门医院检验科 [4]浙江大学医学院附属第二医院药学部 [5]浙江大学医学院附属第二医院检验科

出　　处：《中华检验医学杂志》2023年第7期672-680,共9页Chinese Journal of Laboratory Medicine

摘　　要：他汀类药物作为心血管疾病防治的主要药物,其有效性和毒性反应常存在个体差异,可能发生不同严重程度的他汀类药物相关肌病,常导致他汀类药物依从性较差甚至停药,进而导致心血管事件及死亡率的升高。他汀类药物相关的基因多态性是导致个体反应差异的重要原因,其中溶质载体有机阴离子转运蛋白家族成员1B1(SLCO1B1)和载脂蛋白E(ApoE)基因多态性影响他汀类药物的安全性及有效性。SLCO1B1和ApoE基因多态性可通过实时荧光PCR、芯片杂交、测序、Sanger测序等不同方法进行检测。用药前检测SLCO1B1及ApoE基因多态性,将有助于实现他汀类药物的精准用药,提高调脂疗效,减少或避免药物不良反应的发生。中国中西医结合学会检验医学专业委员会、浙江省免疫学会临床免疫诊断专业委员会及浙江省药理学会治疗药物监测研究专业委员会组织专家对他汀类药物相关基因多态性检测与临床应用进行了讨论,并对一些关键问题给出了共识性观点,形成10条建议,以期为临床安全、合理使用他汀类药物提供指导。Statins,as the main medication for the prevention and treatment of cardiovascular diseases,is often related with large individual differences in their effectiveness and toxicity,and some people might develop statin-related myopathy of different severity,which often leads to poor drug compliance with statins and even withdrawal of statins,and then leads to increased cardiovascular events and mortality.Statins related gene polymorphism is known to be responsible for the observed individual response differences,in which solute carrier organic anion transporter family member 1B1(SLCO1B1)and apolipoprotein E(ApoE)gene polymorphism could significantly affect the safety and efficacy of statins.SLCO1B1 and ApoE gene polymorphisms can be detected by real-time fluorescent polymerase chain reaction(PCR),chip hybridization,sequencing,Sanger sequencing and other methods.Detection of SLCO1B1 and ApoE gene polymorphisms before medication will help realize the precision drug use of statins,improve the efficacy of lipid-regulating therapy,and reduce or avoid the occurrence of adverse drug reactions.Laboratory Medicine Committee of Chinese Association of Integrated Medicine,Clinical Immunodiagnosis Professional Committee of Zhejiang Immunology Society and Therapeutic Drug Monitoring Research Professional Committee of Zhejiang Pharmacological Society organized related experts to discuss the detection and clinical application of statins related gene polymorphism,and the consensus views are achieved and summarized in this document,10 recommendations are formulated to help the safe and rational use of statins on the basis of SLCO1B1 and ApoE gene polymorphisms detection results.

关 键 词：他汀类药物 载脂蛋白E类 基因多态性 肌病 有机阴离子转运蛋白1 

分 类 号：R972[医药卫生—药品]