荧光PCR检测CYP2C19基因分型与氯吡格雷临床疗效的相关性研究  

Association between genetic polymorphisms of CYP2C19 and the clinical response to clopidogrel by fluorescence PCR

作　　者：金欣[1] 陈水平[1] 左向华[1] 佟利威 袁方[1] 许晓跃[1] 吴海涵[1] 李占甲[1] 张伟[1] 黄媛[1] 尹秀云[1] 于农[1] 

机构地区：[1]中国人民解放军第三O七医院检验科,北京100071

出　　处：《中国实验诊断学》2014年第12期1948-1950,共3页Chinese Journal of Laboratory Diagnosis

基　　金：国家高技术发展计划(863计划)(2011AA02A109)

摘　　要：目的通过分析CYP2C19基因型与ADP抑制率之间的关系,探讨CYP2C19基因分型与氯吡格雷抗凝治疗效果的关系。方法选取急性冠脉综合征(ACS)并成功接受经皮冠状动脉介入治疗术(PCI)的患者55例,收集患者EDTA抗凝静脉血提取血液基因组DNA,用实时荧光PCR方法分析CYP2C19基因型,测定每名患者ADP抑制率,用统计学方法分析CYP2C19不同基因型患者ADP抑制率的差异。结果所有入组患者根据基因型不同分为快代谢组占49.09%(27/55),中等代谢组占38.19%(21/55),慢代谢组占12.73%(7/55)。三组ADP抑制率比较,两两相比差异均有统计学意义(P<0.01)。结论 CYP2C19基因多态性与氯吡格雷抵抗存在关联,快代谢型患者PCI术后服用氯吡格雷疗效好于携带基因突变的患者,慢代谢型患者PCI术后服用氯吡格雷疗效差。Objective To investigate the correlation the between genotypes of CYP2C19 and treatment effect of clo-pidogrel by analyzing the relationship between CYP2C19 and the ADP inhibition rates.Methods The EDTA anticoagu-lated venous blood of 5 5 post PCI patients who were diagnosed with acute coronary syndromes were collected,genomic DNAs were extracted and amplified by real-time fluorescent PCR,and then the ADP inhibition rates were detected.The data were analyzed by atatistical software.Results According to the different genotypes,all the patients were divided into three groups.Among the 55 patients,there were 49.09%（27/55）patients with extensive metabolizer group, 38.19% （21/55）patients with intermediate metabolizer group,12.73% （7/55）patients with poor metabolizer group. There were significant differences among the ADP inhibition rates of extensive metabolizer group,intermediate metabo-lizer group and poor metabolizer group.Conclusion There were association between CYP2C19 gene polymorphisms and clopidogrel resistance.The anticoagulant effect of clopidogrel in the CYP2C19 poor metabolism genotype patients was poor.

关 键 词：CYP2C19 氯吡格雷 荧光PCR ADP抑制率 

分 类 号：R541.4[医药卫生—心血管疾病]