CYP2C19基因多态性对氯吡格雷治疗PCI术后疗效的影响  

CYP2C19 gene polymorphisms for the effect of clopidogrel treatment of PCI postoperative patients

作　　者：朱中梁[1] 汪宏良[1] 李振龙[2] 

机构地区：[1]湖北省鄂东医疗集团黄石市中心医院医学检验科,湖北黄石435000 [2]湖北省鄂东医疗集团黄石市中心医院心血管内科,湖北黄石435000

出　　处：《河南大学学报（医学版）》2016年第3期209-211,220,共4页Journal of Henan University:Medical Science

摘　　要：〔目的〕探讨CYP2C19基因多态性对经皮冠状动脉介入(PCI)术后患者服用氯吡格雷治疗效果的影响。〔方法〕1采用荧光法对1 264例行PCI患者进行CYP2C19基因型检测;2从1 264例患者中随机选择资料完整的132例患者,并按照基因型进行分组,比较平均血小板聚集率降低情况、氯吡格雷抵抗和随访12 mon不良心血管事件的再发生情况。〔结果〕1入选检测患者的各基因型分布为快代谢基因型(*1/*1)占总例数41.85%、中间代谢基因型(*1/*2、*1/*3)占总例数46.60%、慢代谢基因型(*2/*2、*2/*3、*3/*3)占总例数11.55%;2经氯吡格雷治疗后,正常代谢组(快代谢基因型)出现氯吡格雷抵抗率14.04%,明显低于弱代谢组(中间代谢基因型和慢代谢基因型)的52.00%,P<0.05;正常代谢组平均血小板聚集降低率(17.65±9.29)%,明显高于弱代谢组(14.16±12.75)%,P<0.05;正常代谢组的不良心血管事件发生率12.28%,明显少于弱代谢组的45.33%,P<0.05。〔结论〕CYP2C19基因多态性对氯吡格雷治疗PCI术后患者疗效具有直接影响,应根据患者基因型指导PCI术后治疗。〔Objective〕To study the CYP2C19 gene polymorphisms for percutaneous coronary intervention（ PCI） in postoperative patients taking clopidogrel treatment effect. 〔Methods〕1 By the method of fluorescence detection of CYP2C19 genotype 1 264 patients who underwent PCI surgery; 2 Data from 1 264 patients were randomly selected 132 patients of complete, and shall be carried out in accordance with the genotype groups, to compare the average platelet aggregation rate between different genotype groups, clopidogrel resistance reduction and followed up for 12 months of adverse cardiovascular events happening again.〔Results〕1For detecting the genotype distribution of fast metabolism in patients with genotype（ ＊ 1/＊ 1） accounted for 41.85%, intermediate metabolism genotype（ ＊ 1 / ＊ 2、＊ 1 / ＊ 3）（ 46.60%）, slow metabolism genotype（ ＊ 2 / ＊ 2、＊ 2 / ＊ 3、＊ 3 / ＊3）（ 11.55%）; 2 After treatment with clopidogrel, the normal metabolic group（ fast metabolism genotype） when clopidogrel resistance rate of 14.04% was lower than that in group weak metabolism（ intermediary metabolism genotype and slow metabolism genotype） 52.00% P〈0.05）; Normal metabolism group average reduce platelet aggregation rate（ 17. 65 ＋ 9. 29） % group is significantly higher than the weak metabolism（ 14. 16 ＋ 12. 75） %（ P〈0.05）; The incidence of adverse cardiovascular events12.28% normal metabolism group was obviously less than 45.33% of the metabolism of weak group（ P〈0.05）.〔Conclusion〕TheCYP2C19 gene polymorphisms in patients with clopidogrel treatment of PCI postoperative curative effect has a direct impact on,should be based on patients with genotype guide PCI in patients with postoperative treatment.

关 键 词：CYP2C19基因多态性 氯吡格雷 经皮冠状动脉介入术 

分 类 号：R541[医药卫生—心血管疾病]