基因指导社区高血压精细管理_周慧君.ppt

Selected genes affecting hypertension drug metabolism: Candidate Gene Selection CYP2C9*3 CYP2C19*2/*3 CYP2D6*10 与中国疾控中心及武汉市卫生局合作， 我们在武汉五个社区医疗中心挑选了350个原发性高血压患者，并确定了这些患者的P450基因的基因型，随后我们对基因型与降压药物的反应做了关联分析。 Patient Selection Age: 37-71 years old Gender: men and women, half and half Sample collection: blood Processes genotyping DNA preparation Sample collection bioinformatics analysis reports Genotype Frequency Genotype Results Frequency Allele RESULT Gene Genotype Phenotype CYP2C9*3 AA Normal Metabolizer CYP2D6 *10 TT Poor Metabolizer CYP2C19*2 GG Normal Metabolizer CYP2C19*3 GG Normal Metabolizer Case 1 Drug Safety Normal Metabolizer Poor Metabolizer Poor metaboliser - these subjects have little or no metabolism function Intermediate metabolizers - these subjects metabolize drugs at a rate somewhere between the poor and normal metabolizers Normal/extensive metaboliser - these subjects have normal function Case 1 Poor metaboliser - these subjects have little or no metabolism function Intermediate metabolizers - these subjects metabolize drugs at a rate somewhere between the poor and normal metabolizers Normal/extensive metaboliser - these subjects have normal function Case 2 Gene Genotype Phenotype CYP2C9*3 AA Normal Metabolizer CYP2D6*10 CT Normal Metabolizer CYP2C19*2 AG Normal Metabolizer CYP2C19*3 GG Normal Metabolizer Drug Safety Case 2 Poor metaboliser - these subjects have little or no metabolism function Intermediate metabolizers - these subjects metabolize drugs at a rate somewhere between the poor and normal metabolizers Normal/extensive metaboliser - these subjects have normal function 我们能为减少高血压患者对降压药产生的不良反应提供有效的方法。 初步研究显示：不同的药物代谢基因的基因型不同，导致了对药物的不同反应，这种基因型的不同也帮助解释了降压药对不同个体的疗效和副作用都会存在差异。 如果社区医疗中心将这种基因的差异性能够划在考虑范围之内，就能够有效地减少降压药对高血压患者的不良反应。 Summary 基因指导儿童安全用药 药物基因检测将成为新生儿接受的一个常规程序, 人们将像知道自己的血型一样，很容易知道自己哪些药物应该谨慎使用。 一个简单明了的个体化医疗的流程是：病人就医时随身带上一张智能卡，上面除了姓名、性别、年龄、生活史等常规资料外，还存储着与药物代谢和