Objectives To observeβ-blockers clinical efficacy based on genotyping for elderly supraventricular arrhythmia treat-ment.Methods 90 elderly patients with supraventricular arrhythmias, mean age 69.6 ±1.8 years.Male:female is 46/44.Classify patients into nine groups by genotyping of β1 receptor gene (ADRB1) and drug metabolizing enzymes (CYP2D6 *10), then ad-justed the sustained-release tablets metoprolol dosage depending on the type of drug metabolism type, ( CYP2D6*10 genotype fast metabolism CC;intermediary metabolism CT;slow metabolism TT) and different drug-sensitive ( ADRB1 genotype insensitive GG;middle-sensitive GC;sensitive CC).The metoprolol dose is from 11.875 mg to 142.5mg, or the maximum tolerated dose.The drug plasma concentration was compared after two weeks, Observe heart rate, blood pressure, blood lipids, blood sugar, liver and kidney metabolic indicators during the treatment.The data statistics in software SPSS 17.0.Results Through the use of different doses of metoprolol extended release tablets for gene-directed therapy, patients of groups carrying CT/CC, TT/CC and TT/GC genotype have significant drug treatment efficiency ( 75%, 70.1% and 60%, P<0.01 ) when compare with group carrying CC/GG genotype (0%).Conclusions In the application of metoprolol gene-directed therapy, we have achieved grate drug treatment efficiency among elderly patients who with supraventricular arrhythmias.The result has great guiding significance for clinical rational drug use.%目的：观察β受体阻滞剂基因导向治疗老年室上性心律失常的临床疗效。方法选取老年室上性心律失常患者90例，平均年龄69．6±1．8岁。其中男性46人，女性44人，通过分型患者个体携带的β1受体基因（ ADRB1）和药物代谢酶（ CYP2D6*10）基因型进行分组观察，然后根据不同的药物代谢型（ CYP2D6*10基因型，快代谢CC；中间代谢CT；慢代谢TT）和不同的药物敏感型（ ADRB1基因型，不敏感型GG；中间敏感型GC；敏感型CC）选择美托洛尔缓释片剂量11．875～142．5mg，或达到最大耐受剂量进行口服个体化治疗。对不同基因型患者分组进行统计分析，比较用药2周后的血药浓度，比较治疗前、治疗后1个月、3个月及6个月的动态心电图、动态血压及血脂、血糖、肝肾功等指标。结果使用不同剂量美托洛尔缓释片进行基因导向治疗中，与携带CC／GG基因型组（0％）相比，CT／CC，TT／CC和TT／GC基因型组患者的药物治疗的显效率（75％，70．1％和60％）结果有显著性差异（P＜0．01）。结论老年室上性心律失常患者根据不同基因型制定个体化给药方案，在应用美托洛尔基因导向治疗中，取得了显著的治疗效果，对临床合理化用药有较大的指导意义。
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