CYP2C19基因多态性与血小板活化率相关性研究  

Relationship between Polymorphism of CYP2C19 Gene and Platelet Activation Rate

作　　者：卢钰 王育斌[1] 汪爱萍 赵金河 Lu Yu;Wang Yubin;Wang Aiping;Zhao Jinhe(Department of Physiology, Medical College of Wuhan University of Science and Technology, Wuhan 430065, China;Department of Cardiology, Wuchang Hospital of Wuhan, Wuhan 430063, China)

机构地区：[1]武汉科技大学医学院生理学系,湖北武汉430065 [2]武汉市武昌医院心内科,湖北武汉430063

出　　处：《湖北民族学院学报（医学版）》2018年第2期22-24,共3页Journal of Hubei Minzu University(Medical Edition)

基　　金：2016年度武汉临床医学(西医药类)科研项目(WX16E21)

摘　　要：目的探讨经氯吡格雷治疗后携带CYP2C19(细胞色素P450的一种同工酶)不同基因型的PCI患者,其基因型与血小板活化率之间的关系。方法选取武昌医院2015-2016年间经PCI治疗后行氯吡格雷抗血小板治疗(常规负荷75 mg/d)的患者200例,根据CYP2C19~*2突变位点基因型的不同,分为三组(慢代谢型、中等代谢型、快代谢型),分别检测各组服用氯吡格雷1年后血小板的活化率、心血管事件(MACE)发生率。结果在200例患者中,慢代谢型有23例(11.5%),其平均血小板活化率为42.3%,有1例(0.43%)发生MACE;中等代谢型有97例(48.5%),其平均血小板活化率为38.7%,有2例(2.06%)发生MACE;快代谢型有80例(40%),其平均血小板活化率为37.4%,有2例(2.5%)发生MACE。每两组之间的血小板活化率未见明显差异(P>0.05),MACE发生率无显著差异(P>0.05)。结论本次实验表明临床上仅仅检测CYP2C19基因型并不能准确指导PCI术后患者的抗血小板药物使用。Objective To investigate the relationship between polymorphism of CYP2C19 gene and platelet activation rate.Methods 200 patients with clopidogrel antiplatelet therapy（ 75 mg/d routine load） after PCI from 2015 to 2016 were divided into three groups（ slow metabolism,secondary metabolism,fast metabolism） according to the different genotype of CYP2C19~＊ 2 mutations. The platelet activation rate and MACE were measured in each group after taking clopidogrel for one year. Results Among the 200 patients,the slow metabolism type had 23 cases（ 11.5%）,with an average platelet activation rate of 42.3%,and 1 case（ 0.43%） of cardiovascular events.The secondary metabolism had 97 cases（ 48.5%）,with an average platelet activation rate of 38.7%,and 2 cases（ 2.06%） of cardiovascular events.The fast metabolism type had 80 cases（ 40%）,with an average platelet activation rate of 37.4%,and 2 cases（ 2.5%） of cardiovascular events.There was no significant difference in platelet activation and MACE between the two groups（ P〉0. 05）. Conclusion This experiment shows that the clinical detection of CYP2 C19 genotype can not accurately guide the use of antiplatelet drugs in patients after PCI.

关 键 词：冠心病 氯吡格雷 CYP2C19基因多态性 血小板活化 

分 类 号：R541.4[医药卫生—心血管疾病]