目的 研究血脂异常患者载脂蛋白（ApoE）、有机阴离子转运蛋白家族成员1B1（SLCO1B1）基因多态性与阿托伐他汀调脂治疗后血脂、肝功能的相关性。方法 选取2020年1月—2023年9月就诊于沧州市人民医院的128例高脂血症患者，阿托伐他汀治疗至少4周，检测ApoE、SLCO1B1基因和血脂、肝功能指标，分析其因型与调脂疗效、肝功能指标关系。结果 阿托伐他汀治疗后，ApoE基因表型E2组三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）水平均较治疗前改善，E3组总胆固醇（TC）、HDL-C、低密度脂蛋白胆固醇（LDL-C）水平均较治疗前改善，E4组HDL-C水平均较治疗前改善，差异有统计学意义（P＜0.05）。治疗后，ApoE基因表型各组丙氨酸转氨酶（ALT）差异无统计学意义，仅E3组谷氨酰转移酶（GGT）差异有统计学意义（P＜0.05）。阿托伐他汀治疗后，SLCO1B1基因表型I型的TC、TG、HDL-C、LDL-C均较治疗前改善，Ⅱ型HDL-C较治疗前改善，差异有统计学意义（P＜0.05）。治疗后，SLCO1B1基因表型各组ALT、GGT差异无统计学意义。结论 临床使用阿托伐他汀时，可检测ApoE、SLCO1B1基因多态性评估降脂疗效，实现阿托伐他汀个体化用药。

Objective To investigate the association of ApoE and SLCO1B1 polymorphism with lipid and liver function in patients with dyslipidemia after lipid-lowering with atorvastatin.Methods A total of 128 patients with dyslipidemia in Cangzhou People's Hospital from January 2020 to September 2023 were collected. The patient received at least 4 weeks of atorvastatin therapy. ApoE genes, SLCO1B1 genes, blood lipids, and liver function indicators were detected. The relationship between their genotype and lipid-lowering efficacy, as well as liver function indicators was evaluate. Results After atorvastatin treatment, the levels of TG and HDL-C of ApoE gene phenotype in E2 group, the levels of TC, HDL-C, LDL-C, and LDL-C in E3 group, and the levels of HDL-C in E4 group were improved compared with before treatment, and the difference was statistically significant (P < 0.05). After treatment, there was no statistically significant difference in ALT among ApoE gene phenotype groups, while only the difference in GGT of E3 group was statistically significant (P < 0.05). After atorvastatin therapy, TC, TG, HDL-C, and LDL-C of SLCO1B1 gene phenotype I improved compared to before treatment, while HDL-C of SLCO1B1 gene phenotype II improved compared to before treatment, with statistical significance (P < 0.05). After treatment, there was no statistically significant difference in ALT and GGT among the SLCO1B1 gene phenotype groups. Conclusion In the clinical application of statins, the lipid-lowering efficacy can be evaluated by detecting APOE and SLCO1B1 gene polymorphisms, and the individualized use of atorvastatin can be realized.

R972

河北省医学科学研究课题（20220310）