目的 研究是否采納基于ABCB1（2677T>G）基因多態(tài)性所給出的個(gè)體化用藥建議對(duì)患者調(diào)脂療效的影響。方法 回顧性選取2020年12月-2022年12月河南理工大學(xué)第一附屬醫(yī)院住院高脂血癥患者85例作為研究對(duì)象，患者均經(jīng)過阿托伐他汀或瑞舒伐他汀連續(xù)治療4周，采用熒光原位雜交法測(cè)定ABCB1（2677T>G）基因多態(tài)性。按照是否采納基于ABCB1（2677T>G）基因多態(tài)性所給出的個(gè)體化用藥建議將85例患者分為采納建議組和未采納建議組，采納建議組中TT、GT型患者均服用瑞舒伐他汀，GG型患者均服用阿托伐他汀；未采納建議組中TT、GT型患者均服用阿托伐他汀，GG型患者均服用瑞舒伐他汀。比較兩組患者治療前后的血脂變化率，觀察是否采納基于ABCB1（2677T>G）基因多態(tài)性所給出的個(gè)體化用藥建議對(duì)患者調(diào)降脂治療的影響。結(jié)果 85例患者中ABCB1（2677T>G）基因頻率分別為GG （25例）29.41%、GT （33例）38.82%、TT （27例）31.77%，ABCB1（2677T>G）基因型分布符合Hardy-Weinberg遺傳平衡。治療前，采納建議組與未采納建議組患者的總膽固醇（TC）、低密度脂蛋白-膽固醇（LDL-C）、高密度脂蛋白-膽固醇（HDL-C）沒有顯著差異。治療后，兩組患者的TC、LDL-C變化率有極顯著差異（P<0.001），而HDL-C變化率差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。TT型患者治療后的HDL-C變化率有顯著差異（P<0.05）；GT型患者治療后，TC、HDL-C變化率均有顯著差異（P<0.05），LDL-C變化率差異具有顯著統(tǒng)計(jì)學(xué)意義（P<0.01）；GG型患者治療后，TC變化率有顯著差異（P<0.05），LDL-C水平變化率的差異具有顯著統(tǒng)計(jì)學(xué)意義（P<0.01），但HDL-C水平變化率的差異不具有統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 采納基于ABCB1（2677T>G）基因多態(tài)性所給出的個(gè)體化用藥建議的患者，其在降低TC、LDL-C水平方面的效果明顯優(yōu)于未采納建議的患者。

Objective To study the effect of individualized medication advice based on ABCB1 (2677T > G) gene polymorphism on lipid-lowering efficacy. Methods A retrospective study was conducted. A total of 85 patients with hyperlipidemia hospitalized in the First Affiliated Hospital of Henan Polytechnic University from December 2020 to December 2022 were selected as subjects. All patients were treated with atorvastatin or rosuvastatin for four weeks. The ABCB1 (2677T > G) gene polymorphism was detected by fluorescence in situ hybridization. patients were divided into advice-accepting group and advice-not-accepting group according to whether they accepted the individualized medication advice given based on ABCB1 (2677T > G) gene polymorphism. In the adviceaccepting group, both TT and GT type patients took rosuvastatin, while GG type patients took atorvastatin. TT and GT type patients in the advice-not-accepting group all took atorvastatin, while GG type patients took rosuvastatin. Effect of individualized medication advice based on ABCB1 (2677T > G) gene polymorphism on lipid-lowering efficacy was studied, the change rate of blood lipid between the two groups before and after treatment were compared. Results ABCB1 (2677T > G) gene frequency in 85 patients were GG (25 cases) 29.41%, GT (33 cases) 38.82%, TT (27 cases) 31.77%, and the ABCB1 (2677T > G) genotype conformed to HardyWeinberg genetic balance. Before treatment, there was no significant difference in TC, HDL-C and LDL-C between the two groups. After treatment, there were significant differences in TC and LDL-C between the two groups (P< 0.001), but there was no significant difference in HDL-C (P > 0.05). It was found that the change rate of HDL-C in patients with ABCB1 2677TT genotype was significantly different (P< 0.05). The change rates of TC, HDL-C and LDL-C in patients with ABCB1 2677GT genotype were significantly different (P< 0.05, 0.01). The change rates of TC and LDL-C in patients with ABCB1 2677GG genotype were significantly different (P< 0.05, 0.01). But the change rate of HDL-C was not significantly different (P > 0.05). Conclusion Patients who accepted individualized medication advice based on ABCB1 (2677T > G) gene polymorphism had significantly better effects in reducing TC and LDL-C levels than those who did not.

R969.3