G蛋白β<sub>3</sub>亚单位C825T基因多态性与富马酸比索洛尔降压疗效的相关性

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (666 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨G蛋白β₃亚单位C825T基因多态性与富马酸比索洛尔降压疗效的相关性。方法选择2018-10至2020-10在解放军总医院第一医学中心心内科住院或门诊就诊的轻、中度原发性高血压患者,均口服5 mg/d比索洛尔,进行GNβ₃-C825T基因型测定,依据基因型分为3组:CC组、CT组、TT组,每组150例,在3组受试者治疗7 d,1、3、6个月后进行随访,测定患者的富马酸比索洛尔药物代谢血药浓度;治疗前、治疗7 d,1、3、6个月后进行24 h动态血压监测,比较患者静息状态下收缩压及舒张压(SBP、DBP),24 h收缩压均数(24 h SBP)、24 h舒张压均数(24 h DBP)、白天收缩压均数(d SBP)、白天舒张压均数(d DBP)、夜间收缩压均数(n SBP)、夜间舒张压均数(n DBP)的组间差异;进行24 h动态心电图监测,比较24 h平均心率、窦性心律震荡水平。结果治疗7 d,随访1、3、6个月TT组富马酸比索洛尔血药浓度均高于CC组及CT组,差异均有统计学意义(P＜0.05),CC组与CT组无统计学差异,3组组内不同时间血药浓度变化均无统计学差异;应用富马酸比索洛尔后,3组患者血压均有下降趋势,其中TT组降压效果＞CT组＞CC组,3组间血压下降水平有统计学差异(P＜0.05);治疗7 d后,动态心电图显示:3组患者心率有下降趋势,TT组＞CT组＞CC组,其中TT组与CT组、CC组比较有统计学差异(P＜0.05),CT组与CC组心率下降无统计学差异;TT组窦性心律震荡水平优于CT组、CC组。结论 G蛋白β₃亚单位C825T基因多态性与富马酸比索洛尔降压疗效之间具有相关性。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	卫玉
	张兰
	汪驰
	朱航

关键词 ： G蛋白β₃亚单位C825T基因, 高血压, 富马酸比索洛尔

Abstract：Objective To study the correlations between Gnβ3-C825T gene polymorphism and the antihypertensive effect of bisoprolol fumarate.Methods Inpatients and outpatients with low-grade and moderate-grade hypertension treated in the First Medical Center received 5 mg/d bisoprolol orally. Their Gnβ₃-C825T genotypes were detected, According to genotypes, these patients were divided into three groups: CC type, CT type and TT type groups, with 150 participants in each group. They were followed up 7 days, 1, 3 and 6 months after treatment.The blood concentration of bisoprolol fumarate was measured.24-hour dynamic blood pressure was recorded, and systolic blood pressure and diastolic blood pressure (SBP and DBP) under resting state were compared.24 h mean systolic blood pressure (24 h SBP), 24 h mean diastolic blood pressure (24 h DBP), daytime mean systolic blood pressure (D SBP), daytime mean diastolic blood pressure (D DBP), night mean systolic blood pressure (N SBP) and night mean diastolic blood pressure (N DBP) were compared between these groups.24-hour dynamic electrocardiograms were recorded to compare the 24-hour average heart rate and the heart rate turbulence (HRT) level.Results The blood concentration of bisoprolol fumarate in the TT group was higher than in the other two groups, and the difference was statistically significant (P< 0.05), but there was no statistically significant difference between the CC group and CT group. There was no significant difference in blood concentration between these patients 1, 3 and 6 months after treatment. After the application of bisoprolol fumarate, blood pressure of the three groups trended down, and the antihypertensive effect was the best in the TT group, followed by the CT group and CC group, and there was statistically significant difference in blood pressure reduction between the three groups (P<0.05). After 7 days of treatment, dynamic electrocardiograms showed that the heart rate of the three groups began to decrease, and there was statistically significant difference between the TT group and the other two groups, but not between the CT group and the CC group. The level of heart rate turbulence (HRT) in the TT group is better than in the other two groups.Conclusions The polymorphism of Gnβ3-C825T genes is correlated with the antihypertensive efficacy of bisoprolol fumarate.

Key words： Gnβ3-C825T gene high blood pressure bisoprolol fumarate

收稿日期: 2021-03-20

ZTFLH:	R954
	R129

基金资助:心馨-默克心血管基金(2017A0002)。

通讯作者: 朱航,E-mail:zhuhang301@126.com

作者简介: 卫玉,硕士,主治医师。

引用本文:

卫玉, 张兰, 汪驰, 朱航. G蛋白β₃亚单位C825T基因多态性与富马酸比索洛尔降压疗效的相关性[J]. 武警医学, 2021, 32(8): 662-666. WEI Yu, ZHANG Lan, WANG Chi, ZHU Hang. Correlations between Gnβ₃-C825T polymorphism and the antihypertensive effect of bisoprolol fumarate. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(8): 662-666.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2021/V32/I8/662

[1]	Seo G W, Kim D K, Kim K H, et al. Impact of Carvedilol versus β1-selective β blockers (bisoprolol, metoprolol, and nebivolol) in patients with acute myocardial infarction undergoing percutaneous coronary intervention[J]. Am J Cardiol, 2015, 116 (10): 1502-1508.
[2]	Cohen B J. A fixed-dose combination of bisoprolol and amlodipine for hypertension: a potential benefit to selected patients [J]. Clin Pharmacol Drug Dev,2017,6(1):6-8.
[3]	Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension[J]. Eur Heart J, 2018, 39(33): 3021-3104.
[4]	Du Y, Zhang J, Xi Y, et al. β1-Adrenergic blocker bisoprolol reverses down-regulated ion channels in sinoatrial node of heart failure rats [J]. J Physiol Biochem, 2016, 72(2): 293-302.
[5]	侯军凯. CYP3A4* 1G 多态性对芬太尼体外代谢影响[D]. 郑州: 郑州大学, 2014.
[6]	Chang P Y, Qin L, Zhao P, et al. Association of regulator of G protein signaling (RGS5) gene variants and essential hypertension in Mongolian and Han populations [J]. Genet Mol Res, 2015, 14(4): 17641-17650.
[7]	Enes A L T, Vicente C, Grégio J V, et al. Regulation of connexins genes expression contributes to reestablishes tissue homeostasis in a renovascular hypertension model[J]. Heliyon, 2020, 6(1): e05406.
[8]	Siffert W. G-protein beta3 subunit 825T allele and hypertension [J]. Curr Hypertens Rep, 2003, 5(1): 47-53.
[9]	Klenke S, Kussmann M. The GNB3 C825T polymorphism as a pharmacogenetic marker in the treatment of hypertension, obesity, and depression [J]. Pharmacogenet Genom, 2011, 21(9): 594-606.
[10]	Nejatizadeh A, Arif E, Assar O, et al. OP-226: GNB3 C825T polymorphism associates with plasma electrolyte balance and susceptibility to hypertension[J]. Int J Cardiol, 2011, 147(2): S91.
[11]	Célia Sousa A, dos Reis R P, Pereira A, et al, The genetic variant C825T of the beta 3 subunit of G protein is associated with hypertension in a Portuguese population[J]. Rev Port Cardiol, 2018, 37(6): 499-507.
[12]	张相杰,黄文平,许有凡. 心力衰竭患者的MDR1和CYP3A4基因多态性与比索洛尔血药浓度的相关性[J]. 广东医学, 2019, 40(15): 2173-2178.
[13]	Chen S P, Yeh L T, Lee H I, et al. Effects of C825T polymorphism of the GNB3 gene on availability of dopamine transporter in healthy volunteers —A SPECT study[J]. Neuro Image, 2011, 56(3): 1526-1530.
[14]	郭继鸿,王思让,谭学瑞,等.窦性心率震荡临床应用中国专家共识(2019)[J]. 实用心电学杂志, 2019, 28(3):166-171.
[15]	Watanabe M A,Marine J E,Sheldon M,et al. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence[J]. Circulation,2002,106(3): 325-330.
[16]	Kim H G,Cheon E J,Bai D S, et a1.Stress and heart rate variability:a meta-analysis and review of the literature[J].Psychiatry Investig, 2018, 15(3):235.
[17]	Addio G, De Felice A, Donisi L, et al. Heart rate turbulence in obstructive sleep apnea syndrome: the effect of short-term CPAP therapy[J]. Eur J Intern Med, 2021(86): 111-114.
[18]	Alegria S, Costa J, Vaz-Carneiro A, et al. Cochrane corner: perioperative beta-blockers for preventing surgery-related mortality and morbidity[J]. Rev Port Cardiol, 2019, 38(10): 691-694.