| SLCO1B1 521 T>C和APOE基因多态性对阿托伐他汀调脂疗效及安全性的影响 |
| 投稿时间：2020-12-21 修订日期：2021-03-01 点此下载全文 |
| 引用本文：刘艳辉,董婧,陆燕,卢曼,丁云鹤,李文艳.SLCO1B1 521 T>C和APOE基因多态性对阿托伐他汀调脂疗效及安全性的影响[J].药学实践杂志,2021,39(3):245~248 |
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| 基金项目:上海市临床药学重点专科建设项目（区属）经费资助（2018）；上海市浦东新区卫生和计划生育委员会临床药学重点学科项目（PWZxk2017-13） |
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| 中文摘要:目的 研究缺血性脑卒中伴血脂异常患者SLCO1B1 521 T>C和APOE基因多态性对阿托伐他汀临床疗效及安全性的影响。方法 收集上海市浦东新区公利医院2018年4月至2018年12月收治的缺血性脑卒中伴血脂异常的患者210例，测定纳入患者SLCO1B1 521 T>C和APOE基因多态性，给予阿托伐他汀20 mg/d口服进行降脂或调脂治疗，于治疗前和治疗后3个月测定其TC、TG、HDL-C、LDL-C水平来评价疗效，测定TBil、ALT、AST、CK水平，以及根据不良反应来评价安全性。结果 SLCO1B1 521 T>C的基因型分布为TT 79.05%，TC 19.05%，CC 1.90%；APOE基因的E2、E3、E4等位基因频率分别为14.28%、67.62%、18.10%，各基因型符合Hardy-Weinberg平衡定律。服药3个月后，APOE不同基因型患者TC、TG、LDL-C、HDL-C变化有显著性差异（P<0.01）。各项安全性指标未发现明显异常。SLCO1B1 521 T>C突变组肌痛发生率高于野生组，有显著性差异（P<0.01）。结论 APOE基因多态性影响阿托伐他汀的调脂疗效，患者SLCO1B1 521 T>C基因可能与阿托伐他汀肌痛不良反应相关。检测SLCO1B1和APOE基因分型有助于血脂个体化治疗，为药物治疗管理患者他汀类药物合理使用提供依据。 |
| 中文关键词:SLCO1B1 APOE 基因多态性 阿托伐他汀 调脂药 不良反应 |
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| Effects of SLCO1B1 521 T>C and APOE gene polymorphisms on lipid-lowering efficacy and adverse reactions of atorvastatin |
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| Abstract:Objective To study the effect of SLCO1B1 521 T>C and APOE gene polymorphisms on the clinical efficacy and safety of atorvastatin in ischemic stroke patients with dyslipidemia.Methods 210 cases of ischemic stroke with dyslipidemia were enrolled from April 2018 to December 2018 to determine SLCO1B1 521 T>C and APOE gene polymorphisms. Patients received atorvastatin 20 mg/d orally. TC, TG, HDL-C, LDL-C levels were measured to evaluate the efficacy 3 months pre-and post- treatment. TBil, ALT, AST, CK levels were assayed with following up adverse reactions to evaluate safety.Results SLCO1B1 521 T>C genotype distribution was TT79.05%, TC19.05%, CC1.90%. E2, E3, E4 allele frequencies of APOE genes were 14.28%, 67.62%, 18.10%. Each genotype conforms to the law of Hardy-Weinberg balance. After three months of medication, there were significant differences in TC, TG, LDL-C, HDL-C changes in patients with different APOE genotypes. No obvious abnormality was found in safety index. The incidence of myalgia in SLCO1B1521 T>C mutant group was significantly higher than that in the wild group (P<0.01).Conclusion Lipid regulation of atorvastatin was affected by APOE gene polymorphism. SLCO1B1521 T>C may be associated with myalgia, the adverse reaction of atorvastatin. The detection of SLCO1B1 and APOE genotyping is helpful for individualized treatment of blood lipids and provides basis for rational use of statins in patients for drug therapy management. |
| keywords:SLCO1B1 APOE gene polymorphism atorvastatin lipid regulating agents adverse drug reactions |
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