我国北方汉族冠心病人群氯吡格雷抵抗相关影响因素的回顾研究  

Retrospective Study on Related Influential Factors of Clopidogrel Resistance in Northern Han Chinese with Coronary Heart Disease

作　　者：邸晓辉[1] 边佳明[1] 徐娟[1] 张梅[1] 

机构地区：[1]北京军区总医院药理科,北京100700

出　　处：《中国药房》2014年第20期1872-1874,共3页China Pharmacy

摘　　要：目的:探讨影响我国北方汉族冠心病人群氯吡格雷抵抗的相关影响因素。方法:选择425例首次行经皮冠状动脉介入术的患者,根据血小板聚集率结果将患者分为氯吡格雷抵抗(CRG)组和氯吡格雷敏感(CSG)组。检测其基因型,分析其CYP2C19*2等位基因携带状态,并分析血小板聚集率等实验室指标和冠心病易感指标等与其是否发生氯吡格雷抵抗的相关性。结果:CYP2C19基因G681A突变携带者(GA、AA)在CRG组与CSG组的分布率分别为64.4%和33.1%,携带突变基因与否在两组间的分布比较差异具有统计学意义(P<0.000 1),而其他非遗传性指标在两组间比较差异无统计学意义(P>0.05)。结论:CYP2C19*2等位基因的携带与氯吡格雷抵抗有显著的相关性,G681A突变基因的携带是导致氯吡格雷抵抗的危险因素,其他非遗传因素与氯吡格雷抵抗的关联不大。OBJECTIVE： To investigate the related influential factors of clopidogrel resistance in northem Han Chinese with coronary heart disease. METHODS： 425 northern Han Chinese patients uncerwent first percutaneous coronary intervention were chosen and divided into clopidogrel resistance group （CRG） and clopidogrel sensitivity group （CSG） according to platelet aggregation rate. Genotypes of them were detected, and the carry of CYP2C19＊2 allele was analyzed; the relevance of biochemical index as platelet aggregation rate and susceptibility index of coronary heart disease with clopidogrel resistance were compared. RESULTS： The frequency of CYP2C19 gene G861A mutation carriers （GA, AA） in CRG and CSG were 64.4% and 33.1%, respectively; there was statistical significance （P〈0.000 1）. The nongenetic factors showed no statistical difference between 2 groups （P〉0.05）. CONCLUSIONS： The carry of CYP2C19＊2 allele is significant relevant with the occurrence of clopidogrel resistance, and G681A mutation is a predictor for clopidogrel resistance. Other nongenetic factors show no significant effect on clopidogrel resistance.

关 键 词：冠心病 CYP2C19 氯吡格雷 经皮冠状动脉介入 

分 类 号：R968[医药卫生—药理学]