北京地区汉族冠心病患者CYP2C19基因多态性的研究分析  

Genetic polymorphism analysis of CYP2C19 in Han nationality patients with coronary heart disease from Beijing

作　　者：孙亚勤[1] 杨胜利[1] 王亮[1] 

机构地区：[1]北京武警总医院心内科,北京100039

出　　处：《心血管康复医学杂志》2016年第3期250-254,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨北京地区汉族冠心病患者细胞色素P450(CYP)2C19基因多态性的分布特征及其与氯吡格雷抵抗、支架内血栓的相关性。方法:入选800例无亲缘关系的冠心病患者,检测其CYP2C19基因型,和ADP诱导的血小板聚集率,确定是否存在氯吡格雷抵抗(CR),并分为CR组(215例),NCR组(585例),比较两组携带基因型及冠脉支架内血栓发生率。结果:CYP2C19分为三种表型,快代谢型(基因型为CYP2C19*1/*1)、中间代谢型(基因型为CYP2C19*1/*2和*1/*3)、慢代谢型(基因型为CYP2C19*2/*2、*2/*3)。入选冠心病患者携带快代谢型*1/*1(41.6%),中间代谢型*1/*2,*1/*3(46.8%)较多,以中间代谢型显著较多;CR组215例,即氯吡格雷抵抗发生率为26.9%(215/800)。与NCR组比较,CR组患者携带快代谢型基因型*1/*1(43.9%比35.3%)明显减少,而携带慢代谢型基因型*2/*2,*2/*3(9.9%比17.2%)明显较多(P<0.05或<0.01)。本研究中共有15例(1.88%)发生确定的支架内血栓,其中10例(4.65%)为CR组,5例(0.85%)为NCR组,即CR组的支架内血栓事件率显著高于NCR组(P<0.01)。结论:北京地区汉族冠心病患者携带P450(CYP)2C19基因中间代谢型最多;氯吡格雷抵抗发生率26.9%,CR组携带慢代谢型基因型显著多于NCR组;CR组的支架内血栓事件率显著高于NCR组。Objective： To explore the genetic polymorphism distribution feature of cytochrome P450 2C19 （CYP2C19） in Han nationality patients with coronary heart disease （CHD） from Beijing and its correlation with clopidsistance and in - stent thrombosis . Methods： A total of 800 CHD patients without kinship were selected . TheirCYP2C19 genotype and ADP induced platelet aggregation rate （PAR） were measured, and determined whether or not clopidogrel resistance （CR） . All 800 patients were divided clopidogrel resistance （CR） group （n = 215）,and non CR （NCR） group （n= 585）. The genotype and coronary in - stent thrombosis rate were compared between two groups . Results： There are three phenotypes for CYP2C19, which is fast metabolism type （genotype is CYP2C19 ＊ 1/ ＊ 1）,medium metabolismtype （ ＊ 1/ ＊ 2 和 ＊ 1/ ＊ 3 ） ,and slow metabolism type （ ＊ 2 / ＊ 2、 ＊ 2/ ＊ 3 ）. There are significant increase of fast metabolism type ＊1/^1 （43. 9% 比 35. 3%） , andmediummetabolismtype ＊ 1 / ^ 2 和 ＊ 1/ ＊ 3 （46. 8% , washighest） ; Clopidogrel resistance rate of CRgroupwas26. 9% （215/800） . Comparedwith NCR group, there was significant reduction in percentage of fat metabolism type ＊ 1/ ＊ 1 genotype （43. 9% vs.35. 5% ） , and significant rise in percentage s of slow metabolism type ＊ 2 / ＊ 2、 ＊ 2 / ＊ 3 ＊ （9. 9% 比 17. 2%）） inCR group, P〈0.05or〈0.01 Instent thrombosis occurred in 15 ca^es （1. 88% ） in enrolled patients, including 10 cases （4. 65% ） from CR group and five ca^es （0. 85% ） from NCR group, that incidence rate of iin CR group was significantly higher than that of NCR group （ P 〈 0. 01）. Conclusion： The（highest） of P450 （CYP） 2C19 medium metabolism type; and incidence rate of clopidogrel resistance was 26. 9% in Han nationality CHD patients from Beijing. Compared with NCR group, there was significant slow metabolism t

关 键 词：细胞色素P450酶系统 多态性 单核苷酸 冠心病 

分 类 号：R541.409[医药卫生—心血管疾病]