CYP2C19、GPIa、ABCB1基因检测在伴发糖尿病的卒中患者抗血小板治疗作用  

Effect of CYP2C19,GPIa,ABCB1 gene detection on antiplatelet therapy in stroke patients with diabetes

作　　者：冯艳[1] 袁丽品[1] 祁亚伟[1] 李学[1] FENG Yan;YUAN Lipin;QI YAwei;LI Xue(Neurology Department,Henan Provincial People's Hospital,Zhengzhou,Henan,China,450003)

机构地区：[1]河南省人民医院神经内科,河南郑州450003

出　　处：《分子诊断与治疗杂志》2022年第3期430-433,438,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省省部共建项目(SBGJ202002005)。

摘　　要：目的探究CYP2C19、GPIa、ABCB1基因检测在伴发糖尿病的卒中患者抗血小板治疗作用。方法分析河南省人民医院神经内科2019年2月至2021年1月收治的108例伴发糖尿病的卒中患者的临床资料,依据CYP2C19基因型分为慢代谢型、中代谢型及快代谢型;依据GPIa基因型分为TC型与CC型;依据ABCB1基因型分为野生型与突变型。依据CYP2C19、GPIa、ABCB1基因的突变数量分为A组、B组与C组。所有患者给予脑卒中及糖尿病常规治疗,通过血栓弹力图仪(TEG)检测患者在通过氯吡格雷治疗1周后的血小板功能、血小板药物抑制率、神经功能。结果基因检测结果显示,按照CYP2C19基因型对108例患者进行分组,其中慢代谢型、中代谢型及快代谢型患者分别有18、48、42例;按照GPIa基因型分组,其中TC型48例、CC型60例;按照ABCB1基因型分组,其中野生型39例、突变型69例。不同CYP2C19、GPIa、ABCB1基因型患者抗血小板药物抑制率、MAADP、神经功能水平的差异无统计学意义(P>0.05)。依据患者检测的基因突变数量将其分为A、B、C组,其中A组19例、B组48例、C组41例。不同突变基因数量患者抗血小板药物抑制率、MAADP、神经功能水平的差异无统计学意义(P>0.05)。结论CYP2C19、GPIa、ABCB1基因的不同型并未对伴发糖尿病的卒中患者抗血小板治疗疗效产生影响。Objective To explore the effect of CYP2C19,GPIa,ABCB1 gene detection on antiplatelet therapy in stroke patients with diabetes.Methods The clinical data of 108 stroke patients with diabetes who were admitted to the Department of Neurology of Henan Provincial People’s Hospital from February 2019 to January 2021 were analyzed.According to the CYP2C19 genotype,they were divided into slow metabolism type,intermediate metabolism type and fast metabolism type.According to GPIa Genotypes,they were divided into TC type and CC type;according to ABCB1 genotype,they were divided into wild type and mutant type.According to the number of mutations in CYP2C19,GPIa and ABCB1 genes,they were divided into group A,group B and group C.All patients were given routine treatment for stroke and diabetes,and thromboelastography(TEG)was used to detect platelet function,platelet drug inhibition rate,and neurological function after 1 week of clopidogrel treatment.Results The results of genetic testing showed that108 patients were grouped according to CYP2C19 genotype,including 18,48,and 42 patients with slow metabolism,intermediate metabolism,and fast metabolism,respectively,grouped according to GPIa genotype,including 48 patients with TC type,60 cases of CC type,grouped according to ABCB1 genotype,including 39 cases of wild type and 69 cases of mutant type.There was no significant difference in the inhibition rate of antiplatelet drugs,MAADP and neurological function among patients with different CYP2C19,GPIa and ABCB1 genotypes(P>0.05).Patients were divided into groups A,B,and C according to the number of gene mutations detected,including 19 cases in group A,48 cases in group B,and 41 cases in group C.There was no significant difference in the inhibition rate of antiplatelet drugs,MAADP and neurological function among patients with different mutated gene numbers(P>0.05).Conclusion Different types of CYP2C19,GPIa,ABCB1 genes did not affect the efficacy of antiplatelet therapy in stroke patients with diabetes.

关 键 词：CYP2C19 GPIa ABCB1 基因检测 脑卒中 糖尿病 抗血小板治疗 

分 类 号：R587.2[医药卫生—内分泌] R743.3[医药卫生—内科学]