CAJ | 학술논문

目的：探讨比索洛尔按CYP2D6及CYP3A4基因导向治疗高血压的疗效。方法：选择100例原发性高血压患者，随机抽取20例进行常规药物治疗（比索洛尔5mg/d ）。余80例患者分为 A、B两组，各40例，根据CYP2D6倡10（A组）及CYP3A4倡1G （B组）基因多态性检测结果分为ACC组（13例）、ACT组（14例）、ATT组（10例），BCC组（21例）、BCT组（17例）、BTT组（0例）。根据测定基因型调整比索洛尔用量， ACC组、BCC组给予10mg/d、ACT组、BCT组给予5mg/d、ATT组、BTT组给予2.5mg/d ，二周后测定各组血药浓度，血压值及心率等相关指标，评价比索洛尔血药浓度与药物代谢酶基因多态性的关系。结果：相同剂量比索洛尔：ACT组与常规治疗组比较，血药浓度，心率，血压等指标无统计学差异（P均＞0.05）；而BCT组与常规治疗组比较，血药浓度[（50.13±23.21） ng/ml比（33.5±19.1） ng/ml]显著升高，心率[（66.5±6.04）次/min比（71.4±5.16）次/min]、血压[（119.48±11.97/71.2±10.30） mmHg比（127.22±10.44/82.4±7.27） mmHg]显著降低（P均＜0.05）。结论：因基因多态性比索洛尔治疗高血压的疗效不一，进行基因导向治疗可显著提高对高血压的疗效。
목적：탐토비색락이안CYP2D6급CYP3A4기인도향치료고혈압적료효。방법：선택100례원발성고혈압환자，수궤추취20례진행상규약물치료（비색락이5mg/d ）。여80례환자분위 A、B량조，각40례，근거CYP2D6창10（A조）급CYP3A4창1G （B조）기인다태성검측결과분위ACC조（13례）、ACT조（14례）、ATT조（10례），BCC조（21례）、BCT조（17례）、BTT조（0례）。근거측정기인형조정비색락이용량， ACC조、BCC조급여10mg/d、ACT조、BCT조급여5mg/d、ATT조、BTT조급여2.5mg/d ，이주후측정각조혈약농도，혈압치급심솔등상관지표，평개비색락이혈약농도여약물대사매기인다태성적관계。결과：상동제량비색락이：ACT조여상규치료조비교，혈약농도，심솔，혈압등지표무통계학차이（P균＞0.05）；이BCT조여상규치료조비교，혈약농도[（50.13±23.21） ng/ml비（33.5±19.1） ng/ml]현저승고，심솔[（66.5±6.04）차/min비（71.4±5.16）차/min]、혈압[（119.48±11.97/71.2±10.30） mmHg비（127.22±10.44/82.4±7.27） mmHg]현저강저（P균＜0.05）。결론：인기인다태성비색락이치료고혈압적료효불일，진행기인도향치료가현저제고대고혈압적료효。
Objective:To explore therapeutic effect of bisoprolol with CYP2D6 and CYP3A4 gene targeting therapy for hypertension .Methods :A total of 100 cases with essential hypertension (EH) were selected ,among them 20 ca-ses were randomly chosen to receive routine medication (bisoprolol 5 mg/d ,routine treatment group ) ,the other 80 patients were equally divided into group A (CYP2D6*10) and group B (CYP3A4*1G) .According to detection results of CYP2D6*10 and CYP3A4*1G gene polymorphism ,they were dived into group ACC (n=13) ,group ACT (n=14) ,group ATT (n=10) ,group BCC (n=21) ,group BCT (n=17) and group BTT (n=0) .Bisoprolol dosage was adjusted according to genotypes :group ACC and group BCC received 10 mg/d ,group ACT and group BCT received 5 mg/d ,group ATT and group BTT received 2.5 mg/d .Blood drug concentration ,blood pressure and heart rate were compared among above groups after two weeks .Relationship between plasma concentration of bisoprolol and gene polymorphism of drug metabolism enzyme was evaluated .Results:Comparison between related groups with same bi-soprolol dosage :there were no significant difference in blood drug concentration ,heart rate and blood pressure be-tween ACT and routine treatment group , P>0.05 all;compared with routine treatment group ,there was significant rise in blood drug concentration [ (33.5 ± 19.1) ng/ml vs .(50.13 ± 23.21) ng/ml] ,significant reduction in heart rate [ (71.4 ± 5.16) times/min vs .(66.5 ± 6.04) times/min] and blood pressure [ (127.22 ± 10.44/82.4 ± 7.27) mmHg vs .(119.48 ± 11.97/71.2 ± 10.30) mmHg] in BCT group , P<0.05 all .Conclusion:Because gene possesses polymorphism ,therapeutic effect of bisoprolol treating hypertension is differing ;the gene targeting therapy may significantly improve therapeutic effect for hypertension .