CYP2C19基因多态性结合DSA造影检查对急性脑梗死患者血管内介入治疗疗效及预后的评估  

Assessment of CYP2C19 gene polymorphism combined withdigital subtraction angiography in the efficacy and prognosis of endovascular interventional therapy in patients with acute cerebral infarction

作　　者：李志安[1] 孙静 胡莹[2] 康丽娟[1] LI Zhian;SUN Jing;HU Ying;KANG Lijuan(Department of Neurology,Baoding First Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院神经内二科,河北保定071000 [2]保定市第一中心医院心内三科,河北保定071000

出　　处：《中国急救复苏与灾害医学杂志》2023年第4期475-478,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省医学科学研究课题计划项目(编号:20220291)。

摘　　要：目的 探讨CYP2C19基因多态性结合数字减影血管造影技术(DSA)造影检查对急性脑梗死患者血管内介入治疗疗效及预后的评估。方法 选取保定市第一中心医院2019年6月—2021年6月收治急性脑梗死患者60例为研究对象,将采取血管内介入治疗的患者分为观察组(n=30),将仅采取单纯静脉溶栓治疗的患者分为对照组(n=30),比较两组CYP2C19基因多态性和DSA造影结果及其与血管再通率、美国国立卫生研究院卒中量表(NHISS)、Fugl-Meyer评测法(FMA)、功能独立性评定(FIM)及并发症发生率相关性,同时分析CYP2C19基因多态性联合DSA造影检测对评价血管内介入治疗急性脑梗死的灵敏度,特异性及准确性。结果观察组共检测330支血管,发现完全闭塞血管8支,狭窄率70%~99%血管30支,狭窄率50%~69%血管15支,狭窄率<50%血管27支;对照组共检测330支血管,发现完全闭塞血管18支,狭窄率70%~99%血管52支,狭窄率50%~69%血管33支,狭窄率<50%血管46支;观察组各项指标均低于对照组(P<0.05);两组CYP2C19基因分型比较,差异无统计学意义(P>0.05);与对照组相比,观察组血管再通率较高,NHISS评分较低,FMA及FIM评分较高,并发症发生率较低(P<0.05);经pearson检验分析,CYP2C19基因多态性,DSA造影结果与血管再通率,NIHSS,FMA,FIM,并发症发生率呈显著正相关且CYP2C19基因多态性联合DSA造影检测对急性脑梗死患者血管内介入治疗疗效及预后评估有重要意义。结论 CYP2C19基因多态性结合DSA造影检查敏感度及特异度较高,可用于对急性脑梗死患者血管内介入治疗疗效及预后的评估。Objective To evaluate the value of CYP2C19 gene polymorphism combined with digital subtraction angiography(DSA)to assess the efficacy and prognosis in patients with acute cerebral infarction through endovascular interventional therapy.Methods Thirty patients with acute cerebral infarction underwent intravenous thrombolysis alone(control group)and 30 patients underwent endovascular interventional therapy(observation group)were selected form June 2019 to June 2021.Peripheral fasting venous blood samples before treatmentto test the CYP2C19 gene polymorphism were collected.Digital subtraction angiography(DSA)was conducted to observe the rate of stenosis and recanalization.National Institutes of Health Stroke Scale(NHISS),Fugl-Meyer evaluationassessment(FMA),and functional independence measure(FIM)were used to assess the rehabilitation of nervous function,extremity function,and daily life ability.Incidence rate of complications was counted.The sensitivity,specificity and accuracy of CYP2C19 gene polymorphism combined with DSA in evaluating endovascular interventional therapy for acute cerebral infarction were also analyzed.Results A total of 330 vessels were detected in the observation group,8 vessels were found to be completely occluded,30 vessels with stenosis rate of 70%~99%,15 vessels with stenosis rate of 50%~69%,and 27 with a stenosis rate<50%;330 vessels were detected in the control group,18 vessels were found to be completely occluded,52 with the stenosis rate of 70%~99%,33 with stenosis rate of 50%~69%,and 46 with a stenosis rate<50%.The rates of various indicators in the observation group were all significantly lower than those in the control group(all P<0.05).There was no significant difference in CYP2C19 genotyping between these two groups(P>0.05).Compared with the control group,the vascular recanalization rate was higher,NHISS score was lower,FMA and FIM scores were higher,and the incidence rate of complications was lower in the observation group,all significantly(all P<0.05).Pearson test analysis showed

关 键 词：CYP2C19基因多态性 DSA造影 急性脑梗死 血管内介入治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]