急性冠脉综合征患者CYP2C19基因多态性与氯吡格雷反应性及与血浆EETs的相关性  

The relationship of CYP2C19 gene polymorphism with clopidogrel responsiveness and the level of EETs in patients with acute coronary syndrome

作　　者：李厚敏[1] 冯燕娴[1] 黄宇理[2] 李妙男[2] 王洪巨[2] 

机构地区：[1]蚌埠医学院附属蚌埠市第三人民医院心内科,233000 [2]蚌埠医学院第一附属医院心内科,233000

出　　处：《实用医学杂志》2017年第6期912-916,共5页The Journal of Practical Medicine

基　　金：蚌埠医学院研究生科研创新计划资助立项项目(编号:Byycx1507);安徽省科技攻关资助项目(编号:1501041154);安徽省高校自然科学研究重大项目(编号:KT20152D30)

摘　　要：目的:评价ACS患者CYP2C19基因多态性与氯吡格雷反应性及与血浆EETs的相关性。方法:选取氯吡格雷和阿司匹林双联抗血小板治疗的ACS患者123例,根据其CYP2C19基因型分为快代谢型(CYP2C19*1/*1)、中等代谢型(CYP2C19*1/*2、CYP2C19*1/*3)和慢代谢型(CYP2C19*2/*2、CYP2C19*2/*3、CYP2C19*3/*3)3组,比较3组PAIR、EETs水平。Logistic回归分析LCR的危险因素。利用ROC曲线检测EETs水平预测CYP2C19基因型的效力。结果:CYP2C19基因快代谢型、中等代谢型和慢代谢型3组之间EETs水平、PAIR差异均有统计学意义(P<0.05)。慢代谢型组较中等代谢型、快代谢型有更高LCR发生率。Logistic回归分析显示携带CYP2C19基因慢代谢型和人血浆EETs含量降低为LCR的危险因素。利用EETs预测CYP2C19基因型的ROC曲线下面积为0.893(95%CI:0.791~0.965,P<0.05),提示效力较好。结论:CYP2C19基因慢代谢型为LCR的独立危险因素,而人血浆EETs水平升高为保护因素。Objective To assess the relationship of CYP2C19 gene polymorphism with clopidogrel respon- siveness and the level of EETs in patients with ACS. Methods A total of 123 patients with ACS receiving aspirin combined with clopidogrel dual antiplatelet were enrolled. According to the results of CYP2C19 genotype, patients were divided into three groups： fast metabolic type, medium metabolic type, and slow metabolism type. The concentration of EETs and PAIR were compared between three groups. Logistic analysis was used to analyze the risk factors of LCR. Results There were differences statistically in level of EETs and PAIR among the three groups （P 〈 0.05 ）. Logistic analysis showed that the slow metabolism of CYP2C19 gene and lower EETs level were risk factors for LCR. The area under the ROC curve was 0.893 （P 〈 0.05） by EETs level to predict the CYP2C19 genotype. Conclusion The slow metabolism of CYP2C19 gene was an independent risk factor for LCR, while the increase of plasma EETs level was a protective factor.

关 键 词：急性冠脉综合征 氯吡格雷低反应 血栓弹力图 CYP2C19 EETS 

分 类 号：R541.4[医药卫生—心血管疾病]