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ADRB2 AA基因型对抗胆碱能药物治疗儿童哮喘的疗效影响
涂彩霞1,任丹阳1,李云巍1,张泉1,沈建玲1,李振坤2,严爱花1,宗静1,李发双1,李惠英1
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(1.昆明医科大学附属儿童医院,云南昆明 650228;2.昆明医科大学第二附属医院,云南昆明 650101)
摘要:
目的:研究ADRB2 (rs1042713) AA基因型对抗胆碱能药物治疗儿童哮喘的应答相关性。方法:选取昆明市儿童医院2017年6月至2019年6月首次诊断的237例哮喘患儿中的80例ADRB2(rs1042713) AA基因型患儿,随机分为试验组和对照组各40例。试验组患儿予以吸入性糖皮质激素联合抗胆碱能药物治疗,对照组患儿予以吸入性糖皮质激素联合长效β2受体激动剂治疗,分别于治疗前后比较两组患儿儿童哮喘控制测试(C-ACT)评分、肺功能、药物应答情况。结果:治疗后试验组较对照组C-ACT评分、肺功能[第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)、最大呼气中段流量(MMEF)]改善较大,差异有统计学意义(P<0.05);治疗后试验组39例哮喘患儿中18例有应答,对照组38例哮喘患儿中7例有应答,试验组药物应答率是对照组的3.8倍(P<0.05,OR=3.80,95%CI:1.35~10.68)。结论:ADRB2(rs1042713)基因多态性对药物应答存在差异,且AA基因型对抗胆碱能药物应答较好
关键词:  ADRB2  基因多态性  抗胆碱能药物  儿童  哮喘
DOI:10.13407/j.cnki.jpp.1672-108X.2021.12.006
基金项目:云南省卫生科技计划资助项目,编号2018NS0174;昆明市卫生科技人才培养项目,编号2019 后备人选-32。
Effects of ADRB2 AA Genotype on Efficacy of Anticholinergic Drugs in the Treatment of Children with Asthma
Tu Caixia1, Ren Danyang1, Li Yunwei1, Zhang Quan2, Shen Jianling1, Li Zhenkun2, Yan Aihua1, Zong Jing1, Li Fashuang1, Li Huiying1
(1. Children’s Hospital of Kunming Medical University, Yunnan Kunming 650228, China; 2. The Second Affiliated Hospital of Kunming Medical University, Yunnan Kunming 650101, China)
Abstract:
Objective: To study the correlation between the response of ADRB2 (rs1042713) AA genotype to anticholinergic drugs in the treatment of children with asthma. Methods: Eighty children with ADRB2 (rs1042713) AA genotype among 237 children with asthma first diagnosed in Children’s Hospital of Kunming Medical University from Jun. 2017 to Jun. 2019 were randomly divided into the experimental group and the control group, with 40 children in each group. The experimental group was treated with inhaled glucocorticoid combined with anticholinergic drugs, while the control group received inhaled glucocorticoid combined with long-acting β2 agonist. Children’s asthma control test (C-ACT) scores, pulmonary function and drug response were compared between two groups before and after treatment. Results: After treatment, the improvements of C-ACT score and pulmonary function [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and maximum midexpiratory flow (MMEF)] in the experimental group were better than those in the control group, with statistically significant differences (P<0.05). After treatment, 18 out of 39 children with asthma in the experimental group responded, and 7 out of 38 children with asthma in the control group responded, the response rate of the experimental group was 3.8 times that of the control group (P<0.05, OR=3.80, 95%CI: from 1.35 to 10.68). Conclusion: ADRB2 (rs1042713) gene polymorphism has different responses to drugs, and AA genotype responds better to anticholinergic drugs.
Key words:  ADRB2  polymorphism  anticholinergic drugs  children  asthma

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