外周血中ABCC3浓度与CYP2C19基因型对PCI术后氯吡格雷抗血小板效应的影响  

Effects of ABCC3 concentration in peripheral blood and CYP2C19 genotype on the antiplatelet effect of clopidogrel after PCI

作　　者：王晶晶 郭晓波 谢娟 阮芙蓉 Wang Jing-jing;Guo Xiao-bo;Xie Juan;Qiu Fu-rong(Xi’an Central Hospital,Xi’an Jiaotong University School of Medicine Pharmacy,Xi'an 710003,China;Xi’an Central Hospital,Xi’an Jiaotong University School of Medicine Department of Hematology,Xi'an 710003,China)

机构地区：[1]西安交通大学医学院附属西安市中心医院药剂科,西安710003 [2]西安交通大学医学院附属西安市中心医院血液科,西安710003

出　　处：《湖南师范大学学报（医学版）》2021年第2期130-133,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探究外周血中ABCC3浓度与CYP2C19基因型对PCI术后氯吡格雷抗血小板效应的影响。方法:纳入在本院进行PCI手术的冠心病患者103例,术后采用氯吡格雷进行抗血小板治疗,利用外周血提取DNA进行CYP2C19基因型分型,同时利用ELISA法测定外周血中ABCC3的水平,观察术后血小板聚集率及达标率。分析CYP2C19基因型与ABCC3水平的相关性,及对氯吡格雷抗血小板效应的影响。结果:本研究PCI术后患者CYP2C19基因型分布符合Hardy-Weinberg平衡。不同代谢型CYP2C19患者的ABCC3水平有较大差异,快代谢型患者的ABCC3水平较中、慢代谢型患者显著降低,且快代谢型患者的抗血小板效应(血小板聚集率及达标率)均优于中慢型代谢型患者。同时,发现ABCC3水平与血小板聚集率具有显著的相关性。结论:CYP2C19基因型与PCI治疗后氯吡格雷抗血小板临床疗效有关,且外周血ABCC3水平与氯吡格雷抗血小板疗效相关性更优,可以为临床治疗提供参考。Objective To investigate the effects of ABCC3 concentration and CYP2C19 genotype on the antiplatelet effect of clopidogrel after PCI.Methods A total of 103 patients with coronary heart disease who underwent PCI in our hospital were enrolled.After operation,clopidogrel was used for antiplatelet therapy,CYP2C19 genotype was typed by DNA extracted from peripheral blood,and ABCC3 level in peripheral blood was determined by ELISA.The platelet aggregation rate and the rate of reaching the standard were observed.To analyze the correlation between CYP2C19 genotype and ABCC3 level and the effect of clopidogrel on platelet resistance.Results The distribution of CYP2C19 genotype in patients after PCI conformed to Hardy-Weinberg equilibrium.ABCC3 levels in different metabolic CYP2C19 patients were significantly different.ABCC3 levels in fast metabolic patients were significantly lower than those in moderate and slow metabolic patients,and the anti-platelet effect(platelet aggregation rate and target rate)in fast metabolic patients were better than those in moderate and slow metabolic patients.At the same time,it was found that there was a significant correlation between ABCC3 level and platelet aggregation rate.Conclusion CYP2C19 genotype is related to the clinical efficacy of clopidogrel in anti-platelet therapy after PCI,and the level of ABCC3 in peripheral blood has a better correlation with the efficacy of clopidogrel in anti-platelet therapy,which can provide reference for clinical treatment.

关 键 词：ABCC3 氯吡格雷 CYP2C19 抗血小板 

分 类 号：R965[医药卫生—药理学]