CYP2C19基因多态性与急性心肌梗死患者炎症指标、临床预后的相关性  

Association of CYP2C19 gene polymorphism with inflammatory indexes and prognosis in patients with acute myocardial infarction

作　　者：吴天源[1] 罗义[1] 吕磊[1] 谭文亮[1] 孙少喜[1] WU Tianyuan;LUO Yi;LV Lei;TAN Wenliang;SUN Shaoxi(Department of Cardiology,Guangzhou First People's Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院心血管内科,广州510180

出　　处：《广州医药》2022年第1期1-5,共5页Guangzhou Medical Journal

基　　金：广州市卫生健康科技项目(20191A011011)。

摘　　要：目的探讨急性心肌梗死患者细胞色素P450酶基因(cytochrome P450,family 2,subfamily C,polypeptide 19,CYP2C19)多态性与高敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)及临床预后的相关性。方法选取2019年5月-2020年5月入住我院心血管内科的急性心肌梗死患者182例作为研究对象,研究对象均接受经皮冠脉介入术,采取RT-PCR方法进行外周全血CYP2C19基因多态性的检测,并进行分组。口服阿司匹林300 mg和氯吡格雷300 mg后次日,测定血中hs-CRP和IL-6含量,治疗后12个月内,随访主要心血管不良事件。结果182例急性心肌梗死患者中,快代谢组(CYP2C19*1/*1)患者最多,为78例(42.8%);中等代谢组(CYP2C19*1/*2、CYP2C19*1/*3),为65例(35.7%);慢代谢型组(CYP2C19*2/*2、CYP2C19*2/*3、CYP2C19*3/*3)最少,为39例(21.5%)。与快代谢组比较,中代谢组及慢代谢组hs-CRP、IL-6水平均升高,差异有统计学意义(P<0.05);与中代谢组比较,慢代谢组患者hs-CRP、IL-6水平均升高,差异有统计学意义(P<0.05)。CYP2C19基因型与hs-CRP及IL-6呈正相关(r=0.163、0.175,P<0.05)。中代谢组、慢代谢组患者1年内主要心血管不良事件发生率高于快代谢组患者(P<0.05)。结论CYP2C19基因型与hs-CRP及IL-6具有相关性,CYP2C19基因型为中代谢型和慢代谢型能够激活机体炎症反应,影响急性心肌梗死患者的临床预后。Objective To explore the correlation of cytochrome P450 gene(CYP2C19)polymorphism with hypersensitive C-reaction protein(hs-CRP),interleukin-6(IL-6)and prognosis in patients with acute myocardial infarction(AMI).Methods A total of 182 patients with AMI admitted to cardiology department from May 2019 to May 2020 were selected as the research objects,all subjects underwent percutaneous coronary intervention(PCI),and CYP2C19 gene polymorphism in peripheral blood was detected by RT-PCR,which was grouping basis.One day after taking aspirin 300 mg and clopidogrel 300 mg orally,the levels of hs-CRP and IL-6 in patients'plasma were measured.The major adverse cardiovascular events(MACE)were followed up for 12 months after treatment.Results Among 182 patients with AMI,78 patients(42.8%)were in the fast metabolism group(CYP2C19*1/*1),65 patients(35.7%)in medium metabolism group(CYP2C19*1/*2,CYP2C19*1/*3),39 patients(21.5%)in the slow metabolism group(CYP2C19*2/*2,CYP2C19*2/*3,CYP2C19*3/*3).Compared with the fast metabolism group,hs-CRP and IL-6 levels in the medium and slow metabolism group were significantly higher(P<0.05);compared with the medium metabolism group,hs-CRP and IL-6 levels in the slow metabolism group were significantly increased(P<0.05).CYP2C19 genotype was positively correlated with hs-CRP and IL-6 levels(r=0.163,0.175,P<0.05).The incidences of MACE in the medium and slow metabolism groups were higher than that in the fast metabolism group(P<0.05).Conclusion CYP2C19 genotypes were associated with hs-CRP and IL-6 levels.Medium and slow metabolism types of CYP2C19 gene can activate the inflammatory response and affect the clinical prognosis of patients with AMI.

关 键 词：急性心肌梗死 CYP2C19 HS-CRP IL-6 预后 

分 类 号：R542.22[医药卫生—心血管疾病]