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目的探讨基因导向美托洛尔个体化治疗与常规治疗高血压的临床疗效、安全性及经济性评价。方法选取2015年1月至2016年2月大连市第三人民医院收治的168例高血压疾病患者作为研究对象,随机将其分为两组,对照组84例,给予常规美托洛尔治疗,观察组84例,根据据β1肾上腺素能受体(β1-AR)及细胞色素P450 2D6(CYP2D6)基因多态性检测结果分为弱代谢组30例、中等代谢组29例、强代谢组25例,给予基因导向型美托洛尔个体化治疗。观察两组患者血压控制情况、临床疗效及不良反应发生情况,并采用成本-效果分析法对两组不同治疗方案所产生的医疗成本进行药物经济学评估。结果观察组患者治疗后收缩压(SBP)、舒张压(DBP)水平、不良反应发生率均明显低于对照组,且治疗的总有效率显著高于对照组,差异均有统计学意义(均P<0.05);但观察组成本-效果比高于对照组,差异有统计学意义(P<0.05)。结论对高血压患者采取基因导向美托洛尔药物个体化治疗效果显著,且安全性较高,但短期治疗难以实现其经济学价值。
Objective To investigate the clinical efficacy, safety and economic evaluation of gene-directed metoprolol individualized treatment and routine treatment of hypertension. Methods A total of 168 patients with hypertension were admitted to the Third People’s Hospital of Dalian City from January 2015 to February 2016. The patients were randomly divided into two groups, 84 patients in the control group received conventional metoprolol treatment, According to the results of β1-AR and CYP2D6 polymorphisms, the observation group consisted of 84 patients with mild metabolic syndrome, 29 with moderate metabolic syndrome, and 25 with strong metabolic syndrome For example, give gene-oriented metoprolol individualized treatment. The blood pressure control, clinical efficacy and adverse reactions were observed in two groups. Pharmacoeconomic evaluation of the medical costs of two groups of different treatment programs was conducted by cost-effectiveness analysis. Results The SBP, DBP and adverse reactions in the observation group were significantly lower than those in the control group after treatment, and the total effective rate of treatment was significantly higher than that of the control group (both were statistically significant P <0.05). However, the cost-effectiveness ratio of the observation group was higher than that of the control group, with significant difference (P <0.05). Conclusions Individualized treatment with gene-guided metoprolol in hypertensive patients is effective and safe, but short-term treatment is difficult to achieve its economic value.