阿司匹林、氯吡格雷抵抗相关基因多态性及其与复发性脑梗死的关系  

Relations between aspirin&clopidogrel resistance-related gene polymorphisms and corresponding recurrent cerebral infarction

作　　者：刘德彬 陈晓璞 陈文杰[2] 黄银婷 何文贞[2] Liu Debin;Chen Xiaopu;Chen Wenjie;Huang Yinting;He Wenzhen(Shantou University Medical College,Shantou 515041,China;The First Affiliated Hospital of Shantou University Medical College,Neurology Department II,Shantou 515041,China)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]汕头大学医学院第一附属医院神经内科二区,广东汕头515041

出　　处：《临床荟萃》2022年第4期320-324,共5页Clinical Focus

摘　　要：目的观察阿司匹林与氯吡格雷抵抗相关基因的多态性,探究其与复发性脑梗死的关系。方法选取2019年4月至2020年12月我院神经内科收治的脑梗死患者98例,回顾性分析脑梗死患者阿司匹林及氯吡格雷抵抗相关基因多态性与性别、复发性脑梗死的关系。结果在脑梗死患者中,阿司匹林重度抵抗型患者在规范抗血小板治疗情况下较敏感型患者更容易出现复发性脑梗死(P<0.05);阿司匹林中/重度抵抗型合并氯吡格雷中/慢代谢型患者比阿司匹林敏感型和(或)氯吡格雷快代谢型患者更容易出现复发性脑梗死(P<0.05);不同氯吡格雷药物相关基因表型复发性脑梗死占比差异无统计学意义(P>0.05);不同性别阿司匹林、氯吡格雷抵抗相关基因型分布差异无统计学意义(P>0.05)。结论治疗脑梗死时进行阿司匹林、氯吡格雷抵抗相关基因型检测十分重要,需要根据检测结果,适当调整治疗方案,以期提高脑梗死治疗效果。Objective To observe aspirin&clopidogrel resistance-related gene polymorphisms,and to explore their relations with recurrent cerebral infarction.Methods A total of 98 cerebral infarction patients were selected from the Department of Neurology in our hospital from April 2019 to December 2020,and the relations between aspirin&clopidogrel resistance-related gene polymorphisms and gender&recurrent cerebral infarction were retrospectively analyzed.Results In patients suffering from cerebral infarction,patients severely resistant to aspirin were more likely to have recurrent cerebral infarction on standard anti-platelet therapy than sensitive patients(P<0.05);the patients suffering from the moderate/severe resistance to aspirin with medium/slow metabolism of clopidogrel complicated were more likely to have recurrent cerebral infarction than aspirin sensitivity and(or)fast metabolism of clopidogrel(P<0.05).The difference in the proportion of different clopidogrel drug-related gene phenotypes wasn’t statistically significant(P>0.05);and the difference in the distribution of aspirin&clopidogrel resistance-related phenotypes with different genders wasn’t statistically significant(P>0.05).Conclusion It is crucial to test aspirin&clopidogrel resistance-related phenotypes in the treatment of cerebral infarction,and it is necessary to appropriately adjust the therapeutic regimen according to test results to improve the therapeutic effects on cerebral infarction.

关 键 词：脑梗死 阿司匹林 氯吡格雷 抵抗 基因多态性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]