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目的研究中国高血脂人群中载脂蛋白A5(ApoA5)-1131bpT>C基因多态性与抗高血脂药物非诺贝特降脂疗效的相关性。方法本研究为前瞻性队列研究。93例初诊或停药4周以上的高血脂病人,经口给予非诺贝特200 mg.d-1(12周)。按照相关血脂变化,观察ApoA5-1131bpT>C各基因型的降血脂效果。基因型测定采用PCR-RFLP方法。研究服药前和服药后血脂的各项指标,同时检测患者各项实验室指标,χ2分析等位基因分布是否符合遗传或基因(hardy-weinberg)平衡。结果 ApoA5-1131bpT>C不同基因型携带者的TG水平有明显差异,T/C型组与C/C型组明显高于T/T型组,而以C/C型组的TG水平最高(P<0.05);经口给予非诺贝特12周后,对服药前后TG值的比较发现,T/T基因型患者下降的程度显著高于T/C组和C/C组(P<0.05),其余的血脂指标则没有此项发现。结论 ApoA5-1131bpT>C基因启动区的基因多态性与TG存在一定关联,该位点T/C转换与高血脂有关,非诺贝特的疗效按T/T组>T/C组>C/C组顺序递减。
Objective To investigate the association between apolipoprotein A5 (ApoA5) -1131bpT> C polymorphism and anti-hyperlipidemic drug fenofibrate-lowering effect in hyperlipidemic Chinese population. Methods This study was a prospective cohort study. 93 patients with newly diagnosed or discontinued hyperlipidemia for more than 4 weeks were given 200 mg.d-1 fenofibrate (12 weeks) orally. In accordance with the changes of blood lipids, observe the ApoA5-1131bpT> C hypoglycemic effect of each genotype. Genotype determination using PCR-RFLP method. To study the indexes of blood lipids before medication and after taking medicine, and to test all the laboratory indexes of patients, χ2 to analyze whether allele distribution is in line with the genetic or gene-hardy-weinberg balance. Results TG levels of ApoA5-1131bpT> C genotype carriers were significantly different, T / C group and C / C group were significantly higher than T / T group, while C / C group TG level was the highest P <0.05). Compared with the TG value before and after oral administration of fenofibrate in 12 weeks, the decline of T / T genotype patients was significantly higher than that of T / C group and C / C group (P <0.05) ), The remaining indicators of blood fat did not find this. Conclusion The gene polymorphism in promoter region of ApoA5-1131bpT> C gene is related to TG. The T / C conversion of this locus is related to hyperlipidemia. The efficacy of fenofibrate is related to T / T group> T / C group> C / C group decreasing order.