PAD患者基因多态性与氯吡格雷抗血小板疗效的相关性研究  

Study on the Correlation of Gene Polymorphism with Antiplatelet Efficacy of Clopidogrel in PAD Patients

作　　者：徐晓宇[1] 林阳[1] 石秀锦[1] 续茜桥 

机构地区：[1]首都医科大学附属北京安贞医院药剂科,北京100029

出　　处：《中国药房》2017年第26期3604-3609,共6页China Pharmacy

基　　金："重大新药创制"科技重大专项(No.2012ZX09303016)

摘　　要：目的:探讨外周动脉疾病(PAD)患者基因多态性与氯吡格雷抗血小板疗效的相关性。方法:收集近年来国内外相关文献,就PAD患者基因多态性与氯吡格雷抗血小板疗效的相关性进行汇总、分析。结果与结论:目前已发现多种与氯吡格雷抗血小板疗效和主要心血管不良事件(MACE)相关的基因,包括细胞色素P_(450)(CYP)2C19、腺苷三磷酸结合盒B亚家族成员1(ABCB1)、对氧磷酶1(PON1)和腺苷二磷酸P2Y12受体(P2Y12)等。其中,CYP2C19~*2、~*3等位基因可能会减弱氯吡格雷的抗血小板作用,两者的相关性已被多项研究证实,且结果具有广泛的一致性;ABCB1 C3435T、PON1 Q192R位点发生突变,可能会导致患者对氯吡格雷的反应性变低,增加MACE发生的风险,但缺乏大规模的前瞻性临床研究,且现有结果并不一致;尚未发现PAD患者P2Y12基因多态性与氯吡格雷疗效显著相关。OBJECTIVE： To investigate the correlation of gene polymorphism in peripheral artery disease （PAD） patients with antiplatelet efficacy of clopidogrel. METHODS ： Reviewing related domestic and foreign literatures in recent years, the correlation of gene polymorphism in PAD patients with antiplatelet efficacy of clopidogrel was summarized and analyzed. RESULTS＆CON- CLUSIONS： At present, a variety of genes associated with clopidogrel antiplatelet efficacy and major adverse cardiovascular events （MACE） have been identified, including cytochrome P450 （CYP） 2C19, adenosine three phosphate binding cassette B subfamily 1 （ABCB1）, paraoxonase 1 （PON1） and adenosine diphosphate P2Y12 receptor （P2Y12）, etc. CYP2C19＊2, ＊3 allele may reduce the antiplatelet effect of clopidogrel. Their correlation has been confirmed by a number of studies, and study results are broadly con- sistent. Mutations in the ABCB1 C3435T and PON1 Q192R sites may lead to a lower response to clopidogrel and increase the risk of MACE; but there is a lack of large-scale prospective clinical studies, and the present results are inconsistent. P2Y12 gene poly- morphism in PAD patients has not been found to be significantly associated with clopidogrel efficacy.

关 键 词：外周动脉疾病 氯吡格雷 基因多态性 CYP2C19基因 ABCB1基因 PON1基因 P2Y12基因 抗血小板作用 

分 类 号：R973.2[医药卫生—药品]