CYP2C19基因多态性对急性冠状动脉综合征患者氯吡格雷抗血小板活性及预后的影响  

Effects of CYP2C19 gene polymorphism on antiplatelet activity of clopidogrel and prognosis in patients with acute coronary syndrome

作　　者：邢金平[1] 来春林[1] 赵建强[1] 刘晓红[2] 胡长青 冀友瑞[1] 陈福恒[1] Xing Jinping;Lai Chunlin;Zhao Jianqiang;Liu Xiaohong;Hu Changqing;Ji Yourui;Chen Fuheng(Department of Cardiology,Shanxi Provincial People′s Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院心内科,太原030012 [2]山西省人民医院特需病房,太原030012

出　　处：《中国药物与临床》2018年第12期2101-2103,共3页Chinese Remedies & Clinics

基　　金：山西省科技厅社会发展方面课题(201603D321078)

摘　　要：目的观察CYP2C19基因多态性对急性冠状动脉综合征(ACS)患者氯吡格雷抗血小板活性和预后的影响。方法选择200例冠心病患者接受阿司匹林100 mg/d、氯吡格雷75 mg/d及低分子肝素5 000 U/12 h治疗,基因检测分为正常基因组(A组)100例,基因突变组(B组)100例。在服用氯吡格雷之前(基线值)、1周后均用全血阻抗法分别测定二磷酸腺苷(ADP)(10 mmol/L)诱导的血小板聚集率(PA)。比较组间患者6个月内主要不良心血管事件(MACE)、支架内血栓、再发心绞痛及出血事件的发生率。结果服用氯吡格雷1周后,2组患者血小板聚集率明显降低,差异有统计学意义(P<0.05);2组间的血小板聚集率差异有统计学意义(P<0.05),2组患者疗效终点差异有统计学意义(P<0.05)。结论 CYP2C19基因多态性对ACS患者氯吡格雷抗血小板活性有影响,对预后有影响。Objective To investigate the effects of CYP2C19 gene polymorphism on antiplatelet activity of Clopidogrel and prognosis in patients with acute coronary syndrome.Methods A total of 200 patients with coronary heart disease were treated with 100 mg/d aspirin,75 mg/d clopidogrel and 5 000 U/12 h low molecular weight heparin.According to gene detection,all patients were divided into normal gene group(groupA,n=100)and gene mutation group(group B,n=100).The platelet aggregation rate induced by 10μmol/L adenosine diphosphate(ADP)was measured by whole blood impedance method at the baseline and at 1 week after taking clopidogrel.The incidences of major adverse cardiovascular events(MACE),stent thrombosis,and recurrent angina and bleeding events within 6 months were compared between the two groups.Results There were no differences in the baseline values between the two groups.The platelet aggregation rate significantly decreased in the two groups at 1 week after taking Clopidogrel compared with that at the baseline,with statistically significant difference(P<0.05).There was statistically significant difference in the platelet aggregation rate between the two groups(P<0.05).There was statistically significant difference in the efficacy endpoint between the two groups(P<0.05).Conclusion CYP2C19 gene polymorphism shows effects on the antiplatelet activity of clopidogrel and prognosis in patients with acute coronary syndrome.

关 键 词：CYP2C19基因型 急性冠脉综合征 氯吡格雷 血小板聚集 

分 类 号：R541.4[医药卫生—心血管疾病]