摘要
目的检测化学药物甲强龙的耐药位点PAI-1(4G/5G)和ABCB1(3435T>C),为使用甲强龙治疗的患者提供精准的用药指导,避免股骨头坏死风险的发生。方法收集94例血液样本,使用荧光探针原位杂交技术对甲强龙耐药位点PAI-1(4G/5G)和ABCB1(3435T>C)进行检测和分析,评估不同患者甲强龙药物使用的可行性。结果 94例患者中,PAI-1(4G/5G)位点检测结果5G5G(野生型)的患者20例(21.28%),检测结果4G5G(杂合突变型)的患者43例(45.74%),检测结果4G4G(纯合突变型)的患者31例(32.98%);ABCB1(3435T>C)位点检测结果TT(野生型)的患者17例(18.09%),检测结果TC(杂合突变型)的患者44例(46.81%),检测结果CC(纯合突变型)的患者33例(35.10%)。12.77%的患者进行激素甲强龙冲击治疗时引起股骨头坏死的风险为低风险,60.63%的患者进行激素甲强龙冲击治疗时引起股骨头坏死的风险为中等风险,26.60%的患者进行激素甲强龙冲击治疗时引起股骨头坏死的风险是高风险。使用卡方检验,激素甲强龙化学药物两个耐药位点间检测结果对于评估股骨头坏死的风险度没有差异。结论在进行糖皮质激素甲强龙冲击治疗前给患者作甲强龙化学药物耐药基因检测,根据检测结果精准用药,可以使26.59%的患者避免股骨头坏死风险的出现,为患者提供安全的用药指导。
Objective To detect the genes of hormone methylprednisolone for the patients who used glucocorticoid therapy and provide them with accurate guidelines to avoid the occurrence of femoral head necrosis.Methods Collected 94cases and detected the PAI-1(4G/5G)and ABCB1(3435T>C)of glucocorticoid methylprednisolone using fluorescent dye solution in situ hybridization specificity probe position,analyzed the test results of genetic loci,and evaluated different patients use different dose of hormone methylprednisolone.Results The cases of 5G5Gof PAI-1(4G/5G)were 20(21.28%),the cases of 4G5Gof PAI-1(4G/5G)were 43(45.74%)and the cases of 4G4Gof PAI-1(4G/5G)were 31(32.98%).The cases of TT of ABCB1(3435t>C)were 17(18.09%),the cases of TC of ABCB1(3435t>C)were 44(46.81%),the cases of CC of ABCB1(3435t>C)were 33(35.10%).12.77%of the patients with hormone methylprednisolone shock treatment caused the risk of femoral head necrosis was low risk,60.63%of the patients with hormone methylprednisolone impact caused the risk of femoral head necrosis as medium risk treatment,and 26.60%of the patients with hormone treatment cause the risk was high risk of femoral head necrosis.Conclusion Before glucocorticoids impact methylprednisolone therapy for patients with methylprednisolone genetic testing,which can guide accurate drug use.Such,26.59%of the patients would avoid the risk of femoral head necrosis,and this also provide safe medication guide for other patients.
作者
张莹
程晓东
胡玉皎
王昊
周铁成
郝晓柯
ZHANG Ying;CHENG Xiao-dong;HU Yu-jiao;WANG Hao;ZHOU Tie-cheng;HAO Xiao-ke(Center of Clinical Laboratory Medicine of People’s Liberation Army,Xijing Hospital,Air Force Modical University,Xi’an 710032,China)
出处
《现代检验医学杂志》
CAS
2019年第2期14-16,19,共4页
Journal of Modern Laboratory Medicine
