RESUMO
Objective To study the correlation between the polymorphism of CYP2C19 gene and the clinical efficacy of compound Danshen dripping pills in treatment of senile coronary atherosclerotic heart disease (CHD) and to provide theoretical basis for rational drug use. Methods Two hundred and six elderly patients with CHD treated in the Third Hospital of Hebei Medical University from June 2015 to December 2017 were screened for genotype detection and classification. All patients were given oral compound Danshen dripping pills, 10 pills each time, 3 times a day, for consecutive 2 months. Serological indexes, electrocardiograph (ECG) monitoring, liver and kidney function testing were performed before and after treatment to evaluate drug efficacy and adverse reactions. Results In senile patients with CHD, after taking compound danshen dripping pills for 2 months, the efficacy in patients with intermediate metabolizer (IM) was more significantly effective than the efficacies of the patients with extensive metabolizer (EM) and poor metabolizer (PM) [clinical efficacy: 95.6% (87/91) vs. 80.5% (33/41), 93.2% (69/74), ECG efficacy: 95.6% (87/91) vs. 78.0% (32/41), 94.6% (70/74)], at the same time, the serum levels of triglyceride (TG) and high-density lipoprotein (HDL) in patients with IM were also higher than those in patients with PM and EM [TG (mmol/L): 1.33±0.52 vs. 1.33±0.41, 1.33±0.27, HDL (mmol/L): 1.58±1.17 vs. 1.44±0.65, 1.38±0.18], and the levels of total cholesterol (TC), low-density lipoprotein (LDL) and hypersensitive C-reactive protein (hs-CRP) were lower than those of PM and EM [TC (mmol/L): 3.48±0.25 vs. 3.56±0.96, 3.51±0.51, LDL (mmol/L): 2.19±0.35 vs. 2.23±0.49, 2.21±0.87, hs-CRP (mg/L): 3.50±1.07 vs. 3.53±1.51, 3.54±2.01]. The incidences of adverse reactions in patients with EM and IM were significantly lower than the incidence of PM [6.8% (5/74), 9.9% (9/91) vs. 31.7% (13/41)], the differences being statistically significant (both P < 0.05). Conclusions CYP2C19 gene polymorphism is closely related to C HD in elderly, in such patients with IM, after taking compound Danshen dripping pills, the efficacy is significant and has low incidence of adverse reactions. Therefore, in the course of clinical treatment of elderly patients with CHD, genetic testing should be carried out to fully consider the influence of CYP2C19 gene polymorphism on the efficacy of the pill, and adopting personalized therapy can increase efficacy and reduce toxicity.
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ObjectiveTo observe the effects of telmisartan on toll-like receptor (TLR) 4 expression in monocytes of mice atherosclerosis (AS)model, and explore the mechanism of inflammation.MethodsAS mice model were established in ApoE-deficient mice fed with high-fat diet,and treated with telmisartan as intervention group. After 8 weeks, serum low density lipoprotein,triacylglycerol and total cholesterol were detected in group fed with high-fat diet and intervention group.TLR 4 expressions in two groups were analyzed by flow cytometry. Results There was no significant difference in levels of blood lipids between the two groups.TLR4 expression in monocytes in telmisartan intervention group was lower than group fed with high-fat diet (P＜0.05).ConclusionsTelmisartan may intervene the inflammation during atherosclerosis by downregulating TLR4 expression in monocytes.