MTHFR C677T联合CYP2C19基因检测在紫杉醇释放冠脉球囊导管术后应用  

Application of MTHFR C677T Combined with CYP2C19 Gene Detection after Percutaneous Paclitaxel Eluting Coronary Balloon Dilatation Coronary Angioplasty

作　　者：王硕 茹琪 张晓婵[2] 杨志瑜[2] 王乐[2] 李柳[2] WANG Shuo;RU Qi;ZHANG Xiaochan;YANG Zhiyu;WANG Le;LI Liu(Dept.of Cardiology,Shijiazhuang People’s Hospital,Shijiazhuang Hebei 050031;Dept.of Cardiology,Hebei Medical University First Hospital,Shijiazhuang Hebei 050011,China)

机构地区：[1]石家庄市人民医院心内科,河北石家庄050031 [2]河北医科大学第一医院心内科,河北石家庄050011

出　　处：《昆明医科大学学报》2022年第6期92-98,共7页Journal of Kunming Medical University

基　　金：河北省卫生健康委员会青年科技课题(20210480);河北省卫生健康委员会科研基金资助项目(20190471)。

摘　　要：目的探讨四氢叶酸还原酶叶酸代谢677基因(MTHFR C677T)联合CYP2C19基因检测在紫杉醇释放冠脉球囊导管术后患者的应用价值。方法纳入行紫杉醇释放冠脉球囊导管术的患者300名,随机分为2组,一组为对照组,按照常规服药方案治疗;一组为实验组,对患者进行MTHFR C677T、CYP2C19基因检测,根据基因检测结果进行针对性药物干预,随访所有患者360 d内发生MACE事件(包括包括心脏死亡、心肌梗死、心力衰竭、心脏原因再次入院、靶血管再次血运重建)、重要脏器并发症(包括脑梗死、脑出血、消化道出血、泌尿系出血、眼底出血、鼻出血)以及药物不良反应(包括肝肾功损伤、胃肠症状、皮疹、血小板或血红蛋白下降)的情况。结果(1)实验组术后360 d的MACE事件发生率、重要脏器并发症显著低于对照组(P<0.05);(2)实验组与对照组的药物不良反应发生率,差异无统计学意义(P>0.05)。结论(1)紫杉醇释放冠脉球囊导管术后患者进行MTHFR C677T、CYP2C19基因检测可显著改善临床疗效;(2)紫杉醇释放冠脉球囊导管术后患者进行MTHFR C677T、CYP2C19基因检测后用药不增加药物不良反应。Objective To investigate the value of MTHFR C677T combined with CYP2C19 gene detection in patients after paclitaxel releasing coronary balloon catheter.Methods 300 patients who underwent paclitaxel releasing coronary balloon catheterization were randomly divided into two groups:first group was the control group,which was treated according to the routine medication scheme;second group was the experimental group.The patients were tested for MTHFR C677T and CYP2C19 genes,and targeted drug intervention was carried out according to the gene test results.Mace events(including cardiac death,myocardial infarction,heart failure,readmission for cardiac reasons,target vessel revascularization),important organ complications(including cerebral infarction,intracerebral hemorrhage,gastrointestinal bleeding,urinary bleeding,fundus hemorrhage and epistaxis)and adverse drug reactions occurred within 360 days of follow-up(including liver and kidney function injury,gastrointestinal symptoms,rash,decreased platelet or hemoglobin)were recorded.Results(1)Theincidence of mace events and important organ complications 360 days after operation in the test group was significantly lower than those in the control group(P<0.05).(2)There was no significant difference in the incidence ofadverse drug reactions between the experimental group and the control group(P>0.05).Conclusions(1)MTHFRC677T and CYP2C19 gene detection in patients after paclitaxel releasing coronary balloon catheter can significantlyimprove the clinical efficacy.(2)After the detection of MTHFR C677T and CYP2C19 genes in patients afterpaclitaxel releasing coronary balloon catheter,the medication did not increase the adverse drug reactions.

关 键 词：MTHFR C677T CYP2C19 紫杉醇释放冠脉球囊导管 MACE 

分 类 号：R541.4[医药卫生—心血管疾病]