细胞色素P4502C19基因多态性对脑卒中并发2型糖尿病患者氯吡格雷反应性的影响  

Effect of cytochrome P4502C19 gene polymorphisms on clopidogrel resistance in stroke patients with type 2 diabetes mellitus

作　　者：孙加琳[1] 李静[1] 郭切[1] 韩冰[1] 刘涛[1] 梁瑜[1] 杨雪[1] 徐文[1] SUN Jia-lin;LI Jing;GUO Qie;HAN Bing;LIU Tao;LIANG Yu;YANG Xue;XU Wen(Department of Pharmacy,The Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong Province,China)

机构地区：[1]青岛大学附属医院药学部,山东青岛266003

出　　处：《中国临床药理学杂志》2021年第13期1638-1640,共3页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81903872)。

摘　　要：目的探讨细胞色素P4502C19(CYP2C19)基因多态性与缺血性脑卒中并发2型糖尿病患者氯吡格雷抵抗(CR)之间的关系。方法将112例缺血性脑卒中并发2型糖尿病患者根据血栓弹力图评估的血小板抑制率分为对照组(非CR组)56例和试验组(CR组)56例。通过聚合酶链反应-限制性片段长度多态性法对CYP2C19基因型进行检测。结合临床和人口统计学数据,评估CYP2C19基因多态性与血小板功能的关联。结果与对照组相比,试验组的CYP2C19*2 A等位基因频率更高(40.18%vs 21.43%,P<0.05)。风险因素分析结果显示,CYP2C19*2突变等位基因的携带与CR风险增加显著相关[比值比(OR)=2.58,95%CI=1.205.52]。研究并未发现CYP2C19*3或*17基因型与CR风险之间存在相关性。结论CYP2C19*2突变等位基因与缺血性脑卒中并发2型糖尿病患者的血小板对氯吡格雷反应减弱和CR风险增加有关。Objective To explore the relationship between cytochrome P4502C19(CYP2C19)polymorphisms and clopidogrel resistance(CR)in patients with ischemic stroke complicated with type 2 diabetes mellitus.Methods In this case-control study,112 consecutive patients were enrolled and divided into control group(non-CR group,n=56 cases)and treatment group(CR group,n=56 cases)according to the platelet inhibition rate assessed by thromboelastography.The CYP2C19 genotypes were detected by polymerase chain reaction-restriction fragment length polymorphism method.Combining clinical and demographic data,the association between CYP2C19 gene polymorphisms and platelet function was evaluated.Results Compared with the control group,the CYP2C19*2 A allele frequency was higher in the treatment group(40.18%vs 21.43%,P<0.05).Risk factor analysis showed that the CYP2C19*2 mutant allele was significantly associated with the increased risk of CR[odds ratio(OR)=2.58,95%CI=1.20-5.52].There was no significant correlation between CYP2C19*3 or*17 genotypes and CR risk.Conclusion The CYP2C19*2 mutant allele was associated with decreased platelet response to clopidogrel and increasedrisk of CR in patients with ischemic stroke complicated with type 2 diabetes melliuts.

关 键 词：缺血性脑卒中 2型糖尿病 细胞色素P4502C19 基因多态性 氯吡格雷抵抗 

分 类 号：R973.2[医药卫生—药品]