论文部分内容阅读
目的探讨细胞色素P450(CYP)3A4*1G、CYP3A5*3及多药耐药(MDR1)C1236T、MDR1 G2677T/A和MDR1 C3435T基因多态性对氨氯地平降压疗效的影响。方法纳入159名原发性高血压患者,予氨氯地平5 mg·d-1干预4周,检测相关基因型,分析不同个体CYP3A4、3A5及MDR1相关基因型分布特征,考察不同单核苷酸多态性(SNP)及MDR1单倍体对氨氯地平降压疗效的影响。结果 CYP3A4*1G*1G基因型舒张压(DBP)下降幅度显著低于CYP3A4*1G*1和CYP3A4*1*1(P<0.05);CYP3A5*3*3基因型DBP下降幅度显著高于CYP3A5*1*3和CYP3A5*1*1(P<0.05);MDR1 C1236T CC、MDR1 G2677T/A AA基因型收缩压(SBP)下降幅度显著高于其他基因型(P<0.05);MDR1 C3435T各基因型治疗前后SBP、DBP下降幅度差异均无统计学意义(P>0.05)。携带MDR1 C3435T CC、MDR1 C3435T CT基因型的患者的DBP下降幅度,女性显著高于男性(P<0.05)。对MDR1单倍体分析,各组单倍体治疗前后SBP、DBP下降幅度差异均无统计学意义(P>0.05)。结论CYP3A5*3、CYP3A4*1G基因多态性可影响氨氯地平降压疗效,MDR1各单倍体未发现与氨氯地平降压疗效相关。
Objective To investigate the effect of C1236T, MDR1 G2677T / A and MDR1 C3435T polymorphisms on the antihypertensive efficacy of amlodipine in patients with cytochrome P450 (CYP) 3A4 * 1G, CYP3A5 * 3 and multidrug resistance (MDR1) Methods A total of 159 patients with essential hypertension were enrolled in this study. Amlodipine 5 mg · d-1 was given for 4 weeks. The genotypes of CYP3A4, 3A5 and MDR1 were analyzed. The distribution of different single nucleotide Effect of polymorphism (SNP) and MDR1 haplotype on the antihypertensive efficacy of amlodipine. Results The decrease of DBP of CYP3A4 * 1G * 1G genotype was significantly lower than that of CYP3A4 * 1G * 1 and CYP3A4 * 1 * 1 (P <0.05), while the decrease of DBP of CYP3A5 * 3 * 3 genotype was significantly higher than that of CYP3A5 * (P <0.05). The decrease of systolic blood pressure (SBP) in MDR1 C1236T CC and MDR1 G2677T / AA genotypes was significantly higher than that in other genotypes (P <0.05). The genotypes of MDR1 C3435T Before and after treatment SBP, DBP decreased no significant difference (P> 0.05). DBP decline in patients with MDR1 C3435T CC, MDR1 C3435T CT genotypes was significantly higher in women than in men (P <0.05). For MDR1 haplotype analysis, there was no significant difference in the decrease of SBP and DBP before and after haploid treatment (P> 0.05). Conclusion CYP3A5 * 3, CYP3A4 * 1G gene polymorphism can affect the antihypertensive efficacy of amlodipine, MDR1 haploids did not find any effect with amlodipine antihypertensive effect.