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作 者:朱中梁[1] 汪宏良[1] 李振龙[2] 尹贵斌[1]
机构地区:[1]鄂东医疗集团黄石市中心医院湖北理工学院附属医院医学检验科,湖北黄石435000 [2]鄂东医疗集团黄石市中心医院湖北理工学院附属医院心血管内科,湖北黄石435000
出 处:《中国临床药理学杂志》2016年第20期1838-1840,1844,共4页The Chinese Journal of Clinical Pharmacology
基 金:黄石市卫计委基金资助项目(2013015)
摘 要:目的观察汉族人群冠心病患者的细胞色素P450 2C19(CYP2C19)基因多态性以及与氯吡格雷反应性的相关性。方法用DNA微阵列芯片法检测626例冠心病患者的CYP2C19基因型,依据第636号及第681号碱基对等位基因功能缺失的不同,分为快代谢型(EM:*1/*1)、中间代谢型(IM:*1/*2、*1/*3)和慢代谢型(PM:*2/*2、*2/*3、*3/*3)3组;用光密度比浊法检测患者入院时及服用氯吡格雷24 h后的最大血小板聚集率(MAP)。结果在626例检测标本中,EM基因型292例,发生率为46.65%;IM基因型为244例,发生率为38.98%;PM基因型90例,发生率为14.38%。服用氯吡格雷24 h后,EM基因型的MAP为(21.29±4.42)%,明显低于IM基因型的(27.54±5.38)%及PM基因型的(32.69±6.18)%,差异均有统计学意义(P<0.05)。有142例(22.68%)患者出现氯吡格雷抵抗,包括17例EM基因型、86例IM基因型、39例PM基因型,EM基因型出现氯吡格雷抵抗的几率为5.83%,明显低于IM基因型的35.25%及PM基因型的43.33%,各代谢型组间比较差异有统计学意义(P<0.05)。结论湖北黄石地区汉族人群冠心病患者CYP2C19基因多态性与氯吡格雷反应性呈相关性,IM基因型及PM基因型患者使用氯吡格雷治疗的效果较差,风险较高。Objective To investigate the correlation between of cytochrome P450 2C19(CYP2C19) gene polymorphism and clopidogrel responsiveness in Han nationality patients with coronary heart disease in Huangshi City of Hubei Province.Methods The CYP2C19 genotype of626 cases of patients with coronary heart disease(CHD) was detected using DNA microarray chip method.On the basis of No.636 and 681 base pairs of alleles missing function different,they were divided into three groups:extensive metabolism(EM:* 1/* 1) type,intermediary metabolism(IM:* 1/* 2、* 1/* 3) type and poor metabolism(PM:* 2* 2 * 2/3 * 3,*/* 3) type.The maximum platelet aggregation rate(MAP) of patients was detected using the optical density of turbidimetric method when they admitted to hospital and treated with clopidogrel after24 h.Results In 626 cases of test specimens,EM type had 292 cases(46.65%),IM type had 244 cases(38.98%),PM type had 90 cases(14.38%).The MAP of EM type was(21.29 ± 4.42) %,significantlylower than that of the IM type with(27.54 ± 5.38) % and PM type with(32.69 ± 6.18) % after taking clopidogrel for24 h,the differences were statistically significant(P 0.05).There were 142 patients(22.68%) with clopidogrel resistance,including 17 cases of EM type(5.83%),86 cases of IM type(35.25%),39 cases of PM type(43.33%),the different in three metabolic type groups on clopidogrel response was statistically significant(P 0.05).Conclusion The CYP2C19 gene polymorphism of Han patients with CHD in Huangshi City of Hubei Province was shown to be correlated with the responses of clopidogrel,the effect of clopidogrel among patients with IM type and PM type genes was poor with high risk.
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