摘要
目的 探讨ATP结合盒转运蛋白C4 rs3741206基因型对慢性肾病患者阿托伐他汀代谢及降脂效果的影响.方法 选取2022年1月至2023年6月期间江苏大学附属医院收治的120例慢性肾病患者作为研究对象,所有患者均给予阿托伐他汀(20 mg/d)治疗;患者在接受治疗6周后利用UPLC-MS/MS测定血浆阿托伐他汀(AT)及其代谢产物水平;检测患者ABCC4 rs3741206基因型并比较不同基因型患者AT及其代谢产物水平、血脂控制情况、不良反应等差异.结果 ABCC4 rs3741206包含AA、AC、CC三个基因型,占比分别为20.83％、55.83％及23.33％;各基因型患者AT及其代谢产物血浆浓度存在较大差异(P＜0.05);AA基因型患者TC、TG及HDL-C变化率显著高于其他基因型患者(P＜0.05),各基因型患者治疗期间不良反应发生率比较不具有统计学意义(P＞0.05).结论 ABCC4 rs3741206基因型可影响阿托伐他汀在慢性肾病患者体内代谢,临床治疗中应依据基因分型制定个体化用药方案.
Abstract
Objective To investigate the effect of ATP binding cassette transporter C4 rs3741206 genotype on ator-vastatin metabolism and lipid-lowering effects in patients with chronic kidney disease.Methods 120 patients with chro-nic kidney disease admitted to Affiliated Hospital of Jiangsu University Jiangsu Zhenjiang from January 2022 to June 2023 were selected as the study subjects,and all patients were treated with atorvastatin(20 mg/d);After 6 weeks of treatment,the patient used UPLC-MS/MS to measure the plasma levels of atorvastatin(AT)and its metabolites;Detect the ABCC4 rs3741206 genotype of patients and compare the differences in AT and its metabolite levels,blood lipid con-trol,adverse reactions,and other indicators among patients with different genotypes.The results showed that ABCC4 rs3741206 contained three genotypes:A A,AC,and CC,accounting for 20.83％,55.83％,and 23.33％,respectively;There are significant differences in plasma concentrations of AT and its metabolites among patients with different geno-types(P＜0.05);The change rates of TC,TG,and HDL-C in patients with AA genotype were significantly higher than those in patients with other genotypes(P＜0.05),and the incidence of adverse reactions during treatment among pa-tients with different genotypes was not statistically significant(P＞0.05).Conclusion The ABCC4 rs3741206 genotype can affect the metabolism of atorvastatin in patients with chronic kidney disease,and personalized medication plans should be developed based on the genotype in clinical treatment.
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