轻型脑梗死患者CYP2C19基因多态性及抗血小板精准治疗对近期预后的影响  

Impact of CYP2C19 gene polymorphism and precise antiplatelet therapy on short-term prognosis in patients with mild cerebral infarction

作　　者：李松良 梁大桐 温思 覃祖业[1] 梁朝莹[1] 黄秀峰[3] 黄翠艳[1] 伍晓雯[2] 何文杰 陈慧 LI Songliang;LIANG Datong;WEN Si;QIN Zuye;LIANG Chaoying;HUANG Xiufeng;HUANG Cuiyan;WU Xiaowen;HE Wenjie;CHEN Hui(Department of Neurology,The First People's Hospital of Qinzhou,Qinzhou 535000,Guangxi,China;Medical Department,The First People's Hospital of Qinzhou,Qinzhou 535000,Guangxi,China;Center for Educational Evaluation and Teacher Development,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]广西钦州市第一人民医院神经内科,广西钦州535000 [2]广西钦州市第一人民医院医务科,广西钦州535000 [3]右江民族医学院教育评价与教师发展中心,广西百色533000

出　　处：《右江医学》2024年第6期491-495,共5页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190112)。

摘　　要：目的探讨轻型脑梗死患者CYP2C19基因多态性以及抗血小板精准治疗对近期预后的影响。方法前瞻性纳入了160例轻型脑梗死患者作为研究对象,通过随机数表将其分为对照组和基因检测组,各80例。对照组患者按照指南接受常规治疗,而基因检测组患者则根据CYP2C19基因检测结果接受个体化治疗。结果CYP2C19基因中超快代谢占比为2.56%,快代谢占比为48.72%,中等代谢占比为38.46%,慢代谢占比为10.26%。两组在入院时NIHSS评分上的差异无统计学意义(P>0.05),但在治疗后NIHSS评分上的差异有统计学意义(P<0.05)。入院时ADL评分差异无统计学意义(P>0.05),治疗后ADL评分差异有统计学意义(P<0.05)。结论轻型脑梗死患者应用基于药物基因组学的精准脑梗死二级预防治疗能更有效改善神经功能,提高日常生活能力。Objective To explore the impact of CYP2C19 gene polymorphism and antiplatelet precision therapy on short-term prognosis in patients with mild cerebral infarction.Methods A total of 160 patients with mild ischemic stroke were included in the study.A randomized number table was used to divide the study participants into control group and gene testing group,with 80 cases in each group.The control group were given conventional treatment according to the guidelines,while the gene testing group were given individualized treatment based on CYP2C19 gene testing results.Results In the CYP2C19 gene,the proportion of ultra-fast metabolism was 2.56%,fast metabolism was 48.72%,moderate metabolism was 38.46%,and slow metabolism was 10.26%.Difference in NIHSS scores on admission between the two groups was not statistically significant(P>0.05),but the difference in NIHSS scores after treatment between the two groups was statistically significant(P<0.05).There was no statistically significant difference in ADL scores at admission(P>0.05),but there was statistically significant difference in ADL scores after treatment(P<0.05).Conclusion The application of precise secondary prevention treatment of cerebral infarction based on pharmacogenomics in patients with mild cerebral infarction can more effectively improve neurological functions and daily living abilities.

关 键 词：CYP2C19 氯吡格雷 轻型脑梗死 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]