氯吡格雷对不同CYP2C19基因分型脑梗死患者的影响  

Effect of clopidogrel on platelet CD62P,PAC-1 expression and NIHSS score in patients with ischemic stroke of different CYP2C19 genotypes

作　　者：李志强[1] 张建平[1] 路文革[1] 李玉林 杨硕[3] 贺显君[1] 马瑜[1] 徐忠海[1] 代全德[1] 赵明[1] 

机构地区：[1]商丘市第一人民医院神经内科,河南商丘476100 [2]河南省生物工程技术研究中心,河南郑州450000 [3]商丘市第一人民医院血液内科,河南商丘476100

出　　处：《中国实用神经疾病杂志》2017年第18期26-29,共4页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技厅科技攻关项目(NO:152102310029)

摘　　要：目的观察氯吡格雷对不同CYP2C19基因分型脑梗死患者血小板CD62P、PAC-1表达和NIHSS评分的影响。方法 56例脑梗死患者根据CYP2C19基因分型分成3组,经氯吡格雷治疗14d,比较3组患者治疗前,治疗后7d、14d的血小板CD62P、PAC-1表达和NIHSS评分的改变。结果 3组患者治疗前血小板CD62P、PAC-1表达和NIHSS评分比较无统计学差异;治疗7d后EM组,IM组的CD62P、PAC-1和NIHSS评分均显著低于治疗前(P<0.05),PM组CD62P、PAC-1和NIHSS评分均低于治疗前,但差异无统计学意义(P>0.05);治疗14d后,EM组和IM组的CD62P、PAC-1和NIHSS评分均显著低于治疗前(P<0.05),也低于治疗后7d(P<0.05),PM组的CD62P、PAC-1和NIHSS评分低于治疗前(P<0.05),也低于后7d,但差异无统计学意义(P>0.05);用药第7天和用药第14天PM组的CD62P、PAC-1表达水平和NIHSS评分均高于EM组(P<0.05)。结论脑梗死患者CYP2C19基因形态可能是影响氯吡格雷临床预后的重要影响因素。Objective To observe the effect of clopidogrel on platelet CD62 P,PAC-1expression and NIHSS score in patients with cerebral infarction of different CYP2C19 genotypes.Methods 56 patients with cerebral infarction were divided into 3groups according to CYP2C19genotype;The therapeutic course for all were 2weeks.The expression of platelet CD62 P,PAC-1and NIHSS score were detected or examined in 5groups before and after treatment.Results There was no significant difference in CD62 P,PAC-1expression and NIHSS score between the 3groups before treatment.The levels of CD62 P,PAC-1and NIHSS on 7days in EM group and IM group after clopidogrel treatment were significantly lower than those before treatment(P<0.05).The levels of CD62 P,PAC-1and NIHSS on 7days in PM group were lower than those before treatment,but there was no statistical difference(P>0.05);The levels of CD62 P,PAC-1and NIHSS on 14 days in EM group and IM group were significantly lower than those before treatment(P<0.05),and also lower than those on 7days after clopidogrel treatment(P<0.05);The levels of CD62 P,PAC-1and NIHSS on 14 days in PM group were significantly lower than those before treatment(P<0.05),and also lower than those on 7days after clopidogrel treatment,but there was no significant difference(P>0.05);The levels of CD62 P,PAC-1and NIHSS in PM group were higher than those in EM group(P<0.05).Conclusion CYP2C19 genetypes may be an important factor that can afect the clinical therapeutic effects of clopidogrel in patients with ischemic stroke.

关 键 词：氯吡格雷 CYP2C19 脑梗死 CD62P PAC-1 

分 类 号：R743.33[医药卫生—神经病学与精神病学]