CYP2C19基因多态性与氯吡格雷ADP抑制率的相关性研究  

Correlation Study between CYP2C19 Gene Polymorphism and Inhibitory Effect on ADP Receptor of Clopidogrel

作　　者：赵冠人[1] 冯端浩[1] 李素[1] 蔡泓敏[1] 

机构地区：[1]解放军第309医院药剂科,北京100091

出　　处：《中国药师》2013年第4期479-482,共4页China Pharmacist

摘　　要：目的:探讨细胞色素P450(CYP)2C19基因多态性与氯吡格雷ADP抑制率的关系。方法:选取176例诊断为急性冠脉综合症并接受经皮冠状动脉介入治疗术(PCI)的患者,采取血标本并提取外周血基因组DNA,将提取后的总DNA进行PCR扩增,扩增产物经纯化后进行双向测序和基因芯片杂交法确定基因型,根据不同的基因型对患者进行分组;测定二磷酸腺苷诱导的血小板聚集率抑制率;所有数据应用SPSS13.0软件进行统计分析。结果:各基因型所占比例:CYP2C19*1/*1为42.05%,CYP2C19*1/*2为32.95%,CYP2C19*1/*3为9.09%,CYP2C19*2/*2为9.66%,CYP2C19*2/*3为6.25%,CYP2C19*3/*3为0%。A组为野生型纯合子组、B组携带有野生型基因与突变基因杂合子和C组突变基因纯合子或杂合子;三组之间ADP抑制率无显著差异。结论:CYP2C19在中国人群中的突变频率较大,然而仅通过基因分型无法预测氯吡格雷的用药剂量,还需要多学科综合研究、多因素综合考虑。Objective： To explore the correlation between the gene polymorphism of CYP2C19 and the inhibitory effect on ADP re-ceptor of clopidogrel. Method： The peripheral blood samples of 176 patients with acute coronary syndromes and treated with pereutane-ous coronary interventions （PCI） were recruited, the genomic DNA was extracted and amplified by PCR, and the genotype was identi- fied by bi-direetional sequencing and gene chips hybridization. The subjects were divided into three groups according to the genotype and evaluated DPAI by thromboelastography （TEG）. All data was analyzed by SPSS 13.0. Result： The percentage of each genotype of CYP2C19 was 42.05% for CYP2C19 ＊ 1/＊ 1, 32.95% for CYP2C19 ＊ 1/＊ 2, 9.09% for CYP2C19 ＊ 1/＊ 3, 9.66% for CYP2C19 ＊ 2/＊ 2, 6.25% for CYP2C19 ＊ 2/＊ 3 and 0% for CYP2C19 ＊ 3/＊ 3. Group A consisted of the patients with wild-type homozygote, group B with wild-type heterozygote and group C with mutant-type bomozygote or heterozygote. There was no significant difference in the inhibitory effect on ADP receptor of elopidogrel among the three groups. Conclusion： The mutation frequency of CYP2C19 is high among Chinese population. Predictive dosage of clopidrogel can＇ t be decided only by CYP2C19 genotype. It needs further study and consideration on this subject.

关 键 词：CYP2C19 基因多态性 氯吡格雷 ADP抑制率 

分 类 号：R968[医药卫生—药理学]