cyp2c19基因检测在氯吡格雷治疗冠状动脉粥样硬化性心脏病的临床意义  

Clinical significance of cyp2c19 gene detection in patients with coronary atherosclerotic heart disease treated with clopidogrel

作　　者：黄德城[1] 王亚双[1] HUANG Decheng WANG Yashuang(Department of Internal Medicine, Shutian Institute of Humen Hospital, Dongguan 523900, CHIN)

机构地区：[1]东莞市虎门医院内科,广东省523900

出　　处：《江苏医药》2017年第12期860-862,共3页Jiangsu Medical Journal

基　　金：广东省东莞市科技攻关项目(201750715020215)

摘　　要：目的探讨cyp2c19基因检测在氯吡格雷治疗冠状动脉粥样硬化性心脏病(冠心病)的意义。方法 120例非经皮冠状动脉介入治疗(PCI)冠心病患者均分为观察组和对照组。对照组使用氯吡格雷治疗。观察组用药前进行cyp2c19基因检测,cyp2c19 618GG型患者给予氯吡格雷,cyp2c19 618GA和AA型患者给予替格瑞洛治疗。治疗12个月,比较两组患者不良心血管终点事件的发生率。结果观察组患者cyp2c19 618GG型34例,cyp2c19 618GA型21例,cyp2c19 618AA型5例,cyp2c19 618A等位基因携带率为43.3%。治疗12个月,观察组不良心血管终点事件发生率为11.7%,低于对照组的38.3%(P<0.05)。结论 cyp2c19基因型检测后选择性使用氯吡格雷能降低非PCI冠心病患者不良心血管终点事件的发生率。Objective To investigate the clinical significance of cyp2c19 gene detection in the patients with coronary atherosclerotic heart disease treated with clopidogrel.Methods A total of 120 cases with coronary atherosclerotic heart disease without percutaneous coronary intervention（PCI）was equally divided into two groups.The patients in group B were treated with clopidogrel.The patients with the genotype of cyp2c19 618 GG in group A were treated with clopidogrel and those with the genotype of cyp2c19 618 GA and cyp2c19 618 AA were treated with ticagrelor.The incidence of end adverse cardiovascular events was compared between two groups after treated for 12 months.Results In group A,34 cases were cyp2c19 618 GG,21 cases were cyp2c19 618 GA and 5 cases were cyp2c19618 AA.The allele carrying rate of cyp2c19 618 A was 43.3%.The incidence of adverse cardiovascular events was lower in group A than that in group B after 12 months treatment（11.7% vs.38.3%）（P〈0.05）.Conclusion The treatment with clopidogrel selectively after cyp2c19 gene detection may reduce the incidence of end adverse cardiovascular events in the patients with coronary atherosclerotic heart disease without PCI.

关 键 词：cyp2c19基因 氯吡格雷 冠状动脉粥样硬化性心脏病 

分 类 号：R541[医药卫生—心血管疾病]