冠状动脉支架内再狭窄患者的氯吡格雷抵抗及CYP2C19基因多态性分析  

Relationship between clopidogrel resistance and CYP2C19 polymorphism in patients with coronary in-stent restenosis

作　　者：刘丽媚[1] 李雪锋[1] 李存仁[1] 古献芳[1] 林斌[1] 曾文峰[1] 

机构地区：[1]梅州市人民医院心血管内一科,广东梅州514031

出　　处：《中国医药导报》2016年第21期50-53,共4页China Medical Herald

摘　　要：目的探讨冠状动脉支架内再狭窄患者与氯吡格雷抵抗（cR）及CYP2C19基因型的关系。方法选取2015年3月。2016年3月于梅州市人民医院心脏疾病防治中心住院行经皮冠状动脉介入术后出现冠状动脉支架内再狭窄的192例患者为研究对象。所有患者手术前后均给予氯吡格雷和阿司匹林治疗，将其分为CR组（44例）和非CR组（148例）．检测两组患者二磷酸腺苷（ADP）诱导的血小板聚集抑制率及CYP2C19基因多态性。结果CR组CYP2C19基因型分别为野生纯合型4例（9．1％），突变纯合型16例（36．4％），突变杂合型24例（54．5％）；非cR组CYP2C19基因型分别为野生纯合型为32例（21．6％），突变纯合型20例（13．5％），突变杂合型96例（64．9％）；两组3种基因型分布差异有高度统计学意义（P〈0．01）。CYP2C19野生纯合型、突变纯合型、突变杂合型出现CR的概率分别为11．1％、44．4％、20．0％（P〈0．01）。结论CR与CYP2C19基因多态性具有相关性。CYP2C19的突变纯合型可能使冠状动脉支架内再狭窄患者发生CR的风险增加。Objective To investigate the relationship between clopidogrel resistance （CR） and CYP2C19 gene polymor- phism in coronary in-stent restenosis. Methods A total of 192 patients with coronary in-stent restenosis after PCI were enrolled from March 2015 to March 2016 in the Heart Disease Control Center of Meizhou People＇s Hospital were se- lected as the study objects, they were treated with Clopidogrel and Aspirin, and were divided into CR group （n=44） and non-CR group （n = 148）. The inhibition rate of platelet aggregation induced by adenosine diphosphate （ADP） and CYP2C19 polymorphism of two groups were determined. Results The frequencies of the three kinds of genotypes （wild- type homozygotes, mutation homozygotes and heterozygotes） of CYP2C19 were 9.1%, 36.4%, 54.5% in CR group and 21.6%, 13.5%, 64,9% in non-CR group, respectively, there were significant differences in the genotypes frequencies between the two groups （P 〈 0.01）. The incidence of CR in wild-type homozygotes, mutatiQn homozygotes and het- erozygotes were 11.1%, 44.4% and 20.0%, respectively （P 〈 0.01）. Conclusion The risk of CR is associated with CYP2C19 gene polymorphism. Mutation homozygotes of CYP2C19 may play an important roles in the occurrence of CR in patients with coronary in-stent restenosis.

关 键 词：支架内再狭窄 氯吡格雷抵抗 CYP2C19基因 基因多态性 

分 类 号：R973.2[医药卫生—药品]