经皮冠状动脉介入术后患者CYP2C19基因多态性与氯吡格雷抵抗的关系  

Relationship Between CYP2C19 Gene Polymorphisms and Clopidogrel Resistance in Patients After PCI

作　　者：孙迪迪[1] 袁冬冬[1] 赵育洁 王军[1] 牛思泉 娄海奎[1] 王本军[1] 

机构地区：[1]郑州市第七人民医院药学部,河南郑州450016 [2]郑州市第七人民医院心内科,河南郑州450016

出　　处：《中国医院用药评价与分析》2016年第9期1175-1177,共3页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：常州四药临床药学科研基金(No.CZSYJJ13005)

摘　　要：目的:探讨经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后患者CYP2C19基因多态性与氯吡格雷抵抗的关系。方法:选取2015年6月—2015年12月郑州市第七人民医院收治的拟行PCI术的冠心病患者73例作为研究对象。采用血栓弹力图仪测定二磷酸腺苷(adenosine diphosphate,ADP)诱导的血小板聚集抑制率,ADP诱导血小板聚集抑制率<30%定义为氯吡格雷抵抗。检测入选患者的CYP2C19基因型,根据检测结果分为快代谢型(*1/*1)、中间代谢型(*1/*2、*1/*3)和慢代谢型(*2/*3、*2/*2、*3/*3)。结果:所有患者中,CYP2C19基因快代谢型26例、中间代谢型35例、慢代谢型12例。3个代谢型组间ADP诱导血小板聚集抑制率比较的差异有统计学意义(P<0.05)。所有患者氯吡格雷抵抗发生率为31.51%(23/73),其中,快代谢型患者氯吡格雷抵抗的发生率明显低于中间代谢型和慢代谢型,差异有统计学意义(P<0.05)。结论:CYP2C19基因多态性与氯吡格雷抵抗相关,携带有中间代谢和慢代谢功能缺失等位基因的患者更容易发生氯吡格雷抵抗。OBJECTIVE： To probe into the relationship between CYP2C19 gene polymorphisms and clopidogrel resistance in patients after PCI. METHODS： 73 patients undergoing PCI admitted into the Seventh People＇s Hospital of Zhengzhou from Jun. 2015 to Dec. 2015 were enrolled. Thromboelastography was used to detect all the patients＇ platelet aggregation inhibition rates induced by adenosine diphosphate（ ADP）. Clopidogrel resistance was defined as platelet aggregation inhibition rates 〈30%. CYP2C19 gene polymorphisms were analyzed and classified as fast metabolic genotypes（ ＊ 1 / ＊ 1）,intermediate metabolic genotypes（ ＊ 1 / ＊ 2,＊ 1 / ＊ 2） and slow metabolic genotypes（ ＊ 2 ＊ 3,＊ 2 / ＊ 2,＊ 3 / ＊ 3）. RESULTS： Of the 73 enrolled cases,26 cases were fast metabolic genotype,35 cases were intermediate metabolism genotype and 12 cases were slow metabolic genotype, with statistically significant difference（ P〈0. 05）. Clopidogrel resistance was present in 31. 51%（ 23 /73） patients. Fast metabolism genotype came up with a lower incidence of clopidogrel resistance than the other two genotypes,with statistically significant difference（ P〈0. 05）. CONCLUSIONS： CYP2C19 gene polymorphisms is associated with clopidogrel resistance,and patients with intermediate metabolism genotype and slow metabolic genotype are more likely to have clopidogrel resistance.

关 键 词：CYP2C19 经皮冠状动脉介入术 氯吡格雷抵抗 基因多态性 

分 类 号：R972[医药卫生—药品]