CYP2C19基因检测对ACS患者PCI术后抗血小板治疗指导价值探究  

Study on the value of CYP2C19 gene detection in the treatment of ACS patients with antiplatelet therapy after percutaneous coronary intervention

作　　者：倪伟欣 吴强[1] 王楚林[1] 林宇鹏[1] 张华弟[1] NI Weixin; WU Qiang ;WANG Chulin; LIN Yupeng ;ZHANG Huadi;(Department of First Cardiology, Jieyang People＇s Hospital, Jieyang 522000, China)

机构地区：[1]广东省揭阳市人民医院心血管内一科,广东揭阳522000

出　　处：《中国医药科学》2018年第18期15-18,共4页China Medicine And Pharmacy

摘　　要：目的探讨CYP2C19基因检测对于急性冠脉综合征患者经皮冠状动脉介入术术后抗血小板治疗的指导价值。方法本研究对象为接受PCI治疗的54例ACS患者根据CYP2C19基因检测结果分为两组,观察组29例,氯吡格雷低代谢,应用替格瑞洛替代,常规组25例术后常规用氯吡格雷治疗,对比两组患者不良心血管事件发生情况。结果观察组治疗1个月、6个月的血小板聚集率低于对照组,术后1个月观察组总体MACE发生率低于对照组,心肌梗死和死亡率总发生率少于对照组,差异有统计学意义(P <0.05),术后6个月,两组患者的总体MACE发生率比较,差异无统计学意义(P> 0.05),但观察组的MACE发生率仍略低于对照组。结论 ACS患者PCI术后应用CYP2C19基因检测,采用替格瑞洛替代氯吡格雷低代谢治疗,可减少不良心血管事件发生。Objective To explore the value of CYP2C19 gene detection in antiplatelet therapy after pereutaneous coronary intervention（PCI） in patients with aeute coronary syndrome（ACS）. Methods Fifty-four patients with ACS after PCI were divided into two groups according to the results of the CYP2C19 gene test. Twenty-nine patients were observed as the observation group, elopidogrel was low metabolism, lreplaeement with tieagrelor, and 25 patients in the conventional group, treatment with elopidogrel. The occurrence of adverse cardiovascular events in the two groups was compared. Results The platelet aggregation rate in the observation group was lower than that in the control group after treatment for 1 month and 6 months. The incidence of MACE in the observation group was lower than that in the control group, and the total incidence of myocardial infarction and mortality was lower in the observation group than in the control group, there was statistical significance（P 〈 0.05）. At 6 months after operation, there was no significant difference in the overall MACE incidence between the two groups（P 〉 0.05）. However, the incidence of MACE in the observation group was still slightly lower than that of the control group. Conclusion The use of CYP2C19 gene after PCI in patients with ACS and low metabolite treatment with tieagrelor instead of clopidogrel can reduce the incidence of adverse cardiovascular events.

关 键 词：CYP2C19基因 急性冠脉综合征 经皮冠状动脉介入术 抗血小板 心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]