CYP3A5基因多态性与终末期肾脏疾病患者使用钙拮抗剂降压疗效的关系

发布时间：2018-01-16 19:08

本文关键词：CYP3A5基因多态性与终末期肾脏疾病患者使用钙拮抗剂降压疗效的关系　出处：《临床肾脏病杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨终末期肾脏疾病(end-stage renal disease,ESRD)患者CYP3A5基因多态性和二氢吡啶类钙拮抗剂(calcium channel blockers,CCB)降压疗效的关系。方法选择在海口市人民医院进行规律腹膜透析或血液透析的患者215例,监测血压的同时,每3个月复查1次血红蛋白(hemoglobin,Hb)、血肌酐(SCr)、全段甲状旁腺素(immunore-active parathyroid hormone,iPTH)水平。根据血压监测结果,将患者分为血压正常组、血压达标组、严重高血压组;另外,根据所使用CCB情况,将使用CCB患者分为硝苯地平控释片组、苯磺酸氨氯地平组及非洛地平缓释片组。采用PCR-直接测序法检测CYP3A5基因多态性,同时利用Hardy-Weinberg平衡检验及多元线性回归分析CYP3A5基因与血压、CCB降压疗效间的关系。结果 CYP3A5基因频率分布符合Hardy-Weinberg平衡分布,提示来自同一孟德尔群体。CYP3A5各基因在年龄、性别、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、△SBP、△DBP、Hb、SCr和iPTH比较无统计学差异(P0.05)。215例患者中血压正常组31例,高血压组184例。血压正常组中GG型14例,GA型11例,AA型6例;高血压组中GG型96例,GA型66例,AA型22例;血压正常组和高血压组各基因型比较无统计学差异(P=0.702),提示CYP3A5各基因型在血压方面无统计学差异;多元线性回归分析CYP3A5各基因型与血压的降幅无明显相关(P0.05),提示CYP3A55基因多态性与CCB的降压疗效无明显相关。结论 CYP3A5基因多态性与ESRD患者的血压和SCr水平无显著相关,同时还发现CYP3A5基因多态性对以CCB为主要降压药物的降压疗效影响可能不大,尚需要在更大样本中进一步检验。
[Abstract]:Objective to investigate the end-stage renal disease of end-stage renal disease. CYP3A5 gene polymorphism and calcium channel blockers, a calcium antagonist of dihydropyridine. Methods 215 patients who underwent regular peritoneal dialysis or hemodialysis in Haikou people's Hospital were selected to monitor blood pressure at the same time. Hemoglobinine (HB) and serum creatinine (SCR) were reexamined every 3 months. The whole parathyroid hormone was immunore-active parathyroid hormoney iPTH. according to the results of blood pressure monitoring. Patients were divided into normal blood pressure group, blood pressure standard group, severe hypertension group; In addition, according to the use of CCB, patients with CCB were divided into nifedipine controlled release tablets group. The polymorphism of CYP3A5 gene in amlodipine benzenesulfonate group and felodipine sustained-release tablet group was detected by PCR-direct sequencing. At the same time, CYP3A5 gene and blood pressure were analyzed by Hardy-Weinberg balance test and multiple linear regression analysis. Results the frequency distribution of CYP3A5 gene was consistent with the equilibrium distribution of Hardy-Weinberg. The results suggest that the genes of CYP3A5 from the same Mendelian population are systolic blood pressure pressure (SBP) in age, sex and systolic pressure. Diastolic blood pressure: DBP, SBP, DBP Hb. There was no significant difference between SCr and iPTH in 31 cases of normal blood pressure group and 184 cases of hypertension group and 11 cases of GG type in 14 cases of normal blood pressure group. AA type in 6 cases; In the hypertension group, there were 96 cases of GG type and 66 cases of GA type and 22 cases of AA type. There was no significant difference in blood pressure between normal blood pressure group and hypertension group (P < 0. 702), indicating that there was no significant difference in blood pressure among CYP3A5 genotypes. Multiple linear regression analysis showed that there was no significant correlation between CYP3A5 genotypes and blood pressure (P 0.05). Conclusion there is no significant correlation between the polymorphism of CYP3A55 gene and the blood pressure and SCr level of ESRD patients. It was also found that the polymorphism of CYP3A5 gene had little effect on the antihypertensive effect of CCB as the main antihypertensive drug, and needed to be further tested in a larger sample.
【作者单位】：中南大学湘雅医学院附属海口医院肾内科;
【基金】：海口市重点科技项目(NO.2013-61)
【分类号】：R692.5
【正文快照】： 终末期肾脏疾病(end-stage renal disease,ESRD)是全球关注的健康问题,其患病率每年以7%以上的速度增长,2008年全球ESRD患者增至231万人,大大增加了各国医疗支出费用[1]。高血压是ESRD患者最常见的并发症,患病率为74.4%?85.2%,而血压控制达标率仅为25. 6%?59.0%ra。大多数ESRD

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