氯吡格雷会诊患者细胞色素P450 2C19等位基因分布与中国人群分布差异及其原因探索  

Cytochrome P450 2C19 gene distribution difference between patients applying for individualized treatment consultation and Chinese healthy populations and the reasons for a preliminary study

作　　者：胡琨[1] 向倩[1] 龚艳君[2] 何云霞[1,3] 王梓凝[1] 谢秋芬[1] 周双[1,3] 崔一民[1] 

机构地区：[1]北京大学第一医院药剂科,北京100034 [2]北京大学第一医院心内科,北京100034 [3]北京大学药学院药事管理与临床药学系,北京100083

出　　处：《中国临床药理学杂志》2016年第21期1974-1976,共3页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81273592;81202592;81573504)

摘　　要：目的分析中国健康人群和氯吡格雷个体化治疗会诊患者的细胞色素P450 2C19(CYP2C19)基因分布特点以及医师申请该会诊的选择偏好。方法对231名健康受试者及93名申请会诊的住院患者进行CYP2C19*2和*3等位基因检测,比较2组人群CYP2C19*2、*3的分布频率的差异,向医师发放问卷,调查医师申请氯吡格雷个体化治疗会诊的偏好。结果 231名健康受试者中CYP2C19*2位点的*1/*1、*1/*2、*2/*2型的分布频率分别为48.92%,40.26%,10.82%;CYP2C19*3位点的*1/*1、*1/*3、*3/*3型的分布频率分别为87.88%,11.69%,0.43%。93名申请会诊的住院患者中CYP2C19*2位点的*1/*1、*1/*2、*2/*2型的分布频率分别为33.33%,55.91%,10.75%,CYP2C19*3位点的*1/*1、*1/*3、*3/*3型的分布频率分别为95.70%,4.30%,0。2组人群的CYP2C19*1/*2的分布频率比较差异有统计学意义(P<0.05),CYP2C19*3的分布频率比较差异无统计学意义(P>0.05)。医师倾向于为腺苷二磷酸聚集率不理想和再次血栓的患者申请会诊。结论医师申请会诊的选择偏好可以部分解释患者与健康人基因分布差异的原因。Objective To know the cytochrome P450 2C19 gene distri- bution in Chinese healthy population and patients, and the doctors＇ pref- erence in applying for elopidogrel genetic individualized treatment consul- tation, and to provide basis for clopidogrel rational use. Methods The polymorphic alleles of CYP2C19 were determined. Compare the differ- ences of CYP2C19 ＊ 2, ＊ 3 frequency between patients and healthy pop- ulations. Issue questionnaire to doctors. Results In 231 healthy people the frequency of CYP2C19＊I/＊I, ＊1/.2, .2/.2 was 48.92%, 40. 26% and 10.82%, respectively, the frequency of CYP2C19 ＊ 1/＊ 1, ＊1/.3, .3/.3 were 87. 88%, 11.69% and0.43%, respective- ly. In 93 patients applied for individualized treatment consultations the frequency of CYP2C19 ＊ 1/＊ 1, ＊ 1/＊ 2, ＊ 2/＊ 2 is 33.33%, 55.91% and 10. 75%, respectively, the frequency of CYP2C19 ＊ 1/＊ 1, ＊ 1/＊ 3, ＊ 3/＊ 3 were 95.70%, 4. 30% and 0, respectively. Compared with healthy populations, patients have higher distribution frequency of CYP2C19 ＊ 1/＊ 2 （P 〈0. 05）. Questionnaire resuhs show that the doctors for patients whose ADP aggregation rate is not ideal or who thrombosis again. Conclusion tend to apply for consultation The doctor＇ s preference for consultation can partially explain the gene distribution difference between patients and the healthy individuals.

关 键 词：细胞色素P450 2C19 氯吡格雷 基因多态性 

分 类 号：R973.2[医药卫生—药品]