TIAM2功能性基因突变对冠心病患者氯吡格雷抗血小板治疗后出血事件的影响  

TIAM2 functional gene mutation has no effect of on bleeding events after clopidogrel antiplatelet therapy in patients with coronary heart disease

作　　者：李新新[1,2] 钟诗龙[2] 李园[3] 韦素惠 张梦珍[2] 祁周措[2] 陈纪言[4] 劳海燕[2] 

机构地区：[1]南方医科大学,广州市510515 [2]广东省人民医院(广东省医学科学院),广州市510080 [3]广东药学院,广州市510006 [4]广东省心血管病研究所,广州市510080

出　　处：《实用医学杂志》2014年第7期1080-1083,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81373486);广东省科技计划项目(编号:2012A030400062,2010B031600163)

摘　　要：目的:探讨TIAM2功能性基因突变与冠心病患者经皮冠状动脉介入治疗(PCI)术后服用抗血小板药物氯吡格雷后出现出血事件的关联性。方法:从广东省人民医院顺序入选120例PCI术后接受氯吡格雷抗血小板治疗的中国汉族患者。应用PCR测序对PCI术后随访6个月的患者进行TIAM2启动子区基因分型检测。结果:随访6个月后,失访7例,实为113例,其中19例出现出血,94例未出现出血;合并糖尿病(OR=3.115)或是同时服用他汀类药物(OR=11.539)者出血风险可能较高,但无统计学差异(P<0.05);TIAM2启动子区有3个变异(c.3168+3116C>T、c.3168+3261A>G、c.3168+3596A>C),分为野生型、杂合型、纯合型,在出血患者中的概率分别为36.84%、52.63%、10.53%,存在一定的连锁状态,对氯吡格雷抗血小板治疗出现出血事件无显著的关联性(P>0.05)。结论:TIAM2功能性基因突变对氯吡格雷抗血小板治疗出现出血事件无显著影响。ObJective To explore the correlation of the TIAM2 functional gene mutations with the bleeding events in patients with coronary heart disease who undergone PCI and postoperative taken anti-platelet drug clopi- dogrel. Methods One hundred and twenty Chinese Han patients who had undergone PCI and postoperative taken anti-platelet drug clopidogrel were orderly enrolled from Guangdong General Hospital. Followed for 6 months after PCI, PCR sequencing was applied to test TIAM2 promoter region genotyping assay. Results After follow-up six months, 113 cases were remained lost of 7 cases,, including 19 cases with bleeding and 94 cases without bleed- ing; Bleeding risk in patients with diabetes mellitus （OR = 3.115） or taking statins （OR = 11.539）, may be high, but there was no significant difference （P 〉 0.05） ; TIAM2 promoter region had three variants （c.3168 ＋3116C 〉T, c.3168＋3261A〉G, c.3168＋3596A〉C）, including wild-type, heterozygous, and homozygous. The probability of pa- tients with bleeding were 36.84%, 52.63% and 10.53%, and there is a certain chain of state, but the genotype was not significantly correlated with bleeding events of clopidogrel antiplatelet therapy （P 〉 0.05）. Conclusion Clopi- dogrel antiplatelet therapy bleeding events were not significantly correlated with TIAM2 functional gene mutation.

关 键 词：冠心病 TIAM2基因 氯吡格雷 出血事件 

分 类 号：R541.4[医药卫生—心血管疾病]