CYP2C19基因为中间代谢的患者PCI术后ADP抑制率与支架内再狭窄的相关性  

Association between ADP inhibition rate and in-stent restenosis in patients with CYP2C19 medium-metabolized genotype after percutaneous coronary intervention

作　　者：郑小芳[1] 吴黎明[2] 

机构地区：[1]福建医科大学附属第三医院,福建福州350108 [2]福建医科大学附属协和医院,福建福州350001

出　　处：《心血管病防治知识（学术版）》2017年第11期21-24,共4页Prevention and Treatment of Cardiovascular Disease

摘　　要：目的分析影响CYP2C19基因为中间代谢的患者PCI术后支架内再狭窄的危险因素,探讨ADP抑制率对支架内再狭窄的影响。方法入选2015年4月-2016年4月于我院行择期PCI术,且CYP2C19基因为中间代谢的患者202例,术后1年内复查冠脉造影,根据造影结果分为支架内再狭窄组(n=28)和非再狭窄组(n=174);比较两组临床基线情况,并分析CR等因素对支架内再狭窄的影响。结果两组在年龄、性别、BMI等情况差异无统计学意义(P>0.05);而支架内再狭窄组与支架内未见再狭窄组相比:吸烟率更高、置入支架个数更多、支架总长度更长、CR发生率更高(P均<0.05),差异均有统计学意义;Logistic回归分析示,CR[OR=11.3,95%可信区间(CI):(3.59-36.1),P<0.05]、支架总长度[OR=1.09,95%CI:(1.05-1.13),P<0.05]是支架内再狭窄发生的危险因素。结论 CR、置入支架总长度是支架内再狭窄发生的危险因素。Objective To investigate the risk factors for in-stent restenosis in patients with CYP2C19 mediummetabolized genotype after percutaneous coronary intervention （PCI）, as well as the influence of ADP inhibition rate on in-stent restenosis. Methods A total of 202 patients with CYP2C19 medium-metabolized genotype who underwent selective PCI in our hospital from April 2015 to April 2016 were enrolled. Coronary angiography was performed again at 1 year after surgery, and according to these results, the patients were divided into in-stent restenosis group with 28 patients and non-restenosis group with 114 patients. Baseline data were compared between the two groups, and the influence of the factors including CR was analyzed. Results There were no significant differences in age, sex, and body mass index between the two groups （P〉0.05）. Compared with the non-restenosis group, the in-stent restenosis group had a significantly higher proportion of patients with a smoking history, a significantly higher number of stents implanted, a significantly longer total stent length, and a significantly higher incidence rate of CR （all P〈0.05）. The logistic regression analysis showed that CR （odds ratio [OR]=11.3, 95% confidence interval [CI] 3.59-36.1, P〈0.05） and total stent length （OR=1.09, 95% CI 1.05-1.13, P〈0.05） were risk factors for in-stent restenosis. Conclusion CR and total stent length are risk factors for in-stent restenosis.

关 键 词：CYP2C19基因 中间代谢 ADP抑制率 经皮冠状动脉血管成形术 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]