CYP2C19基因分型指导PCI术后抗血小板治疗的临床观察  

Clinical observation of antiplatelet therapy based on CYP2C19 genotype after PCI

作　　者：刘庆艳[1] 白静[1] 申文彬[1] 赵宇[1] 邓磊[1] 张明华[2] 

机构地区：[1]解放军总医院心血管内科,北京100853 [2]解放军总医院临床药学实验室,北京100853

出　　处：《中华保健医学杂志》2016年第4期271-273,共3页Chinese Journal of Health Care and Medicine

基　　金：解放军总医院临床扶持基金(2014FC-TSYS-1011)

摘　　要：目的根据氯吡格雷细胞色素P45酶2C19(CYP2C19)基因型,对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后个体化抗血小板治疗和常规治疗的临床预后进行比较。方法入选296例行PCI术患者,按随机数字表法分为抗血小板基因检测组(n=150例)和常规治疗组(n=146例),其中基因检测组患者均行CYP2C19基因型检测,并根据基因型给予氯吡格雷剂量加倍或换用替格瑞洛;常规治疗组患者常规给予氯吡格雷75 mg/d。6个月后随访观察两组患者主要不良心血管事件(MACE)发生率。结果两组支架内血栓发生率、死亡和(或)心肌梗死发生率分别为1.34%和4.11%、0.67%和3.41%(P<0.05);出血事件发生率为1.34%和2.05%(P>0.05)。结论根据CYP2C19基因型进行个体化给药可降低ACS患者PCI术6个月后支架内血栓和MACE的发生。Objective To investigate the effects of personalized antiplatelet therapy according to CYP2C19 genetype in ACS patients after PCI. Methods 296 patients were enrolled in the study and randomly divided into A（personalized therpy）and B（conventional therpy）groups. CYP2C19 were screened in group A and patients received personalized clopidogrel treatment. For group B,patients received 75 mg/d clopidogrel without dectecting CYP2C19 genetype. All patients received follow-up visits 6 months after antiplatelet treatment. Results The rate of stent thrombosis（ST）,myocardial infarction（MI） and death in group A were significantly lower than those in group B： 1.34% vs 4.11%（P 0.05） and 0.67%vs 3.41%（P 0.05） respectively. The incidence of bleeding events did not suggest significant difference between the 2 groups. Conclusion The incidence of stent thrombosis and MACE significantly decrease after personalized antiplatelet therapy according to CYP2C19 genetype.

关 键 词：氯吡格雷 CYP2C19 抗血小板治疗 不良心血管事件 

分 类 号：R543.31[医药卫生—心血管疾病]