CYP2C19*2/*3基因多态性与急性非致残性缺血性卒中复发的相关性分析  

Analysis of correlation between CYP2C19*2/*3 gene polymorphisms and recurrence of acute non-disabling ischemic stroke

作　　者：汪进丁[1] 万姗姗[2] 罗江洪[3] 徐明[1] 姚德斌 万和斌[1] WANG Jinding;WAN Shanshan;LUO Jianghong;XU Ming;YAO Debin;WAN Hebin(Department of Neurology,Jiujiang First People's Hospital,Jiangxi Province,Jiujiang332000,China;Department of Outpatient,Jiujiang First People's Hospital,Jiangxi Province,Jiujiang332000,China;Public Health and Health Management,Gannan Medical College,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省九江市第一人民医院神经内科,江西九江332000 [2]江西省九江市第一人民医院门诊部,江西九江332000 [3]赣南医学院公共卫生与健康管理学院,江西赣州341000

出　　处：《中国当代医药》2023年第35期75-79,共5页China Modern Medicine

基　　金：江西省卫生健康委员会科技计划项目(202140284)。

摘　　要：目的分析CYP2C19*2/*3基因多态性与规律服用氯吡格雷治疗的急性非致残性缺血性卒中复发的相关性。方法选取2020年1月至2021年3月就诊于九江市第一人民医院神经内一科的120例被诊断为急性非致残性缺血性脑卒中患者作为研究对象,采用京因药物基因床旁检测系统检测CYP2C19基因多态性,随访1年内入组患者缺血性卒中复发情况,比较规律服用氯吡格雷的脑卒中患者卒中复发与CYP2C19*2/*3基因多态性的关系。结果对入组120例的患者进行随访1年,其中18例(15.00%)出现卒中复发。CYP2C19*2/*3基因缺陷型患者的复发风险较基因正常型高,差异有统计学意义(χ^(2)=4.804,P<0.05)。复发组的CYP2C19*2/*3基因缺陷型、糖尿病、颅内动脉狭窄患者占比及体重指数(BMI)、低密度脂蛋白胆固醇(LDL-C)水平、同型半胱氨酸(Hcy)水平均高于未复发组,差异具有统计学意义(P<0.05)。多因素logistic回归分析结果提示CYP2C19*2/*3基因缺陷型(β=1.912,OR=9.845,95%CI:5.531~15.479)、高血压病(β=1.389,OR=4.242,95%CI:1.185~12.919)、糖尿病(β=1.742,OR=5.707,95%CI:1.762~18.479)、颅内动脉狭窄(β=1.251,OR=2.875,95%CI:1.195~8.459)、BMI(β=1.497,OR=4.469,95%CI:1.648~12.121)、LDL-C(β=1.840,OR=7.444,95%CI:1.151~14.147)、Hcy(β=1.252,OR=2.352,95%CI:1.280~6.383)是急性非致残性缺血性卒中患者复发的独立危险因素(P<0.05)。结论规律服用氯吡格雷的急性非致残性缺血性卒中患者,CYP2C19*2/*3基因缺陷型卒中复发风险较基因正常型高,基因缺陷型是急性非致残性缺血性卒中患者卒中复发的独立危险因素之一。Objective To analyze the correlation between CYP2C19*2/*3 gene polymorphisms and prognostic recurrence of acute non-disabling ischemic stroke treated with Clopidogrel regularly.Methods A total of 120 cases of acute non-disabling ischemic stroke were enrolled in the group,in the Department of Neurology,Jiujiang First People's Hospital from January 2020 to March 2021.And the polymorphism of CYP2C19 gene was detected by the point of care testing of Jingyin drug gene detection system,the recurrence of ischemic stroke was followed up within one year,and the relationship between stroke recurrence and CYP2C19 gene polymorphism in patients taking Clopidogrel regularly was analyzed.Results A total of 120 patients were followed for one year,and 18(15.00%)of them had stroke recurrence.Compared with fast metabolizers,patients with CYP2C19*2/*3 gene defect had a higher risk of recurrence,the difference was statistically significant(χ^(2)=4.804,P<0.05).The proportion of patients with CYP2C19*2/*3 gene defect type,diabetes,intracranial artery stenosis and body mass index(BMI),low density lipoprotein cholesterol(LDL-C),homocysteine(Hcy)levels in the recurrence group were higher than those in the non-recurrence group,the differences were statistically significant(P<0.05).The results of multifactorial logistic regression analysis suggested that CYP2C19*2/*3 gene defect type(β=1.912,OR=9.845,95%CI:5.531-15.479),hypertension(β=1.389,OR=4.242,95%CI:1.185-12.919),diabetes mellitus(β=1.742,OR=5.707,95%CI:1.762-18.479),intracranial artery stenosis(β=1.251,OR=2.875,95%CI:1.195-8.459),BMI(β=1.497,OR=4.469,95%CI:1.648-12.121),LDL-C(β=1.840,OR=7.444,95%CI:1.151-14.147),and Hcy(β=1.252,OR=2.352,95%CI:1.280-6.383)were independent risk factors for recurrence of patients with acute non-disabling ischemic stroke(P<0.05).Conclusion In patients with acute non-disabling ischemic stroke who regularly take Clopidogrel,the CYP2C19*2/*3 gene defect type has a higher risk of stroke recurrence than the fast metabolic type,and the gene defect type

关 键 词：基因多态性 氯吡格雷 非致残性缺血性卒中 复发 

分 类 号：R741[医药卫生—神经病学与精神病学]