通讯作者: 盛晓生, sxsjhzj@163.com

DOI：10.12201/bmr.202501.00078

• 摘要：目的 探讨核转录因子-κB1（nuclear transcription factor-κB1，NF-κB1）启动子区-94ins/del ATTG（rs28362491）位点多态性对冠心病（coronary atherosclerotic heart disease，CHD）患者阿托伐他汀降脂抗炎疗效的影响。方法 选择2022年6月至2024年06月浙江省金华市人民医院CHD患者180例作为研究对象，服用阿托伐他汀钙20 mg·d -1。检测NF-κB1基因rs28362491位点基因型，分析患者用药前、用药1和6个月后的血脂及炎症因子水平指标，观察治疗期间不良反应发生情况。结果 180例CHD患者行基因检测，分为DD型 46 例、ID型76例、II型58例，基因型分布符合 Hardy-Weinberg 平衡（P＞0.05）。治疗前，3组间高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL-C）无显著差异（P＞0.05）；DD型总胆固醇（total cholesterol，TC）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL-C）、白细胞介素（interleukin，IL）-6、白细胞介素（interleukin，IL）-8、肿瘤坏死因子（tumor necrosis factor，TNF）-α水平高于ID型和II型（P＜0.05），ID型和II型的TC、LDL-C、IL-6、IL-8、TNF-α水平无显差异（P＞0.05）。治疗1、6个月后，3组患者TC、LDL-C、IL-6、IL-8、TNF-α水平较治疗前明显下降（P＜0.05）；同一时间节点，ID型和II型TC、LDL-C、IL-6、IL-8、TNF-α水平指标变化率高于DD型（P＜0.05）。随访半年内，不同基因型胃肠道症状、肌肉症状、肝脏症状、神经系统症状发生率比较无显著差异（P＞0.05）。结论 CHD患者阿托伐他汀疗效与NF-κB1基因rs28362491位点多态性相关，II、ID型的疗效优于DD基因型。

  关键词： 基因多态性; 冠心病; 阿托伐他汀; 血脂

   

  Abstract: Objective To investigate the effect of polymorphism at the -94ins/del ATTG (rs28362491) site in the promoter region of nuclear transcription factor-κB1 (NF-κB1) on the lipid-lowering and anti-inflammatory efficacy of atorvastatin in patients with coronary heart disease(CHD). Method A total of 180 CHD patients from Jinhua PeoplesHospital in Zhejiang Province from June 2022 to June 2024 were selected as the study subjects and treated with atorvastatin calcium 20 mg·d-1.Detect the genotype of the NF-κB1 gene rs28362491 locus, analyze the levels of blood lipids and inflammatory factors in patients before medication,1and 6 months after medication,and observe the occurrence of adverse reactions during treatment. Results,180 CHD patients underwent genetic testing and were divided into DD type 46, ID type 76, and II type 58. The genotype distribution followed Hardy Weinberg equilibrium (P＞0.05). Before treatment, there was no significant difference in high density lipoprotein cholesterol (HDL-C) levels among the three groups (P＞0.05);The levels of total cholesterol (TC),low density lipoprotein cholesterol(LDL-C), interleukin-6(IL-6), interleukin-8(IL-8),and tumor necrosis factor-α (TNF-α) in DD type were higher than those in ID type and II type (P＜0.05), while there was no significant difference in TC, LDL-C, IL-6, IL-8, and TNF-αlevels between ID type and II type (P＞0.05). After 1 and 6 months of treatment, the levels of TC, LDL-C,IL-6,IL-8, and TNF -α in the three groups of patients decreased significantly compared to before treatment (P＜0.05);At the same time point,the change rates of TC,LDL-C,IL-6,IL-8,and TNF-αlevels in ID and II types were higher than those in DD type (P＜0.05).Within six months of follow-up,there was no significant difference in the incidence of gastrointestinal symptoms, muscle symptoms,liver symptoms, and neurological symptoms among different genotypes (P＞0.05).Conclusion The efficacy of atorvastatin in CHD patients is associated with the rs28362491 polymorphism of the NF-κB1 gene,with II and ID genotypes showing better efficacy than DD genotypes.

  Key words: Gene polymorphism; Coronary heart disease; Atorvastatin; Blood lipid

  提交时间：2025-01-26

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• 序号	提交日期	编号	操作
  1	2025-01-06	bmr.202501.00078V1	下载

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