336例冠心病经皮冠脉介入术患者CYP2C19基因多态性分布及抗血小板治疗方案分析  

Distribution of CYP2C19 Gene Polymorphisms and Analysis of Antiplatelet Therapy Regimens in 336 Patients undergoing Percutaneous Coronary Intervention for Coronary Artery Disease

作　　者：智勇刚 潘蕾羽 王晓义[1] ZHI Yong-gang;PAN Lei-yu;WANG Xiao-yi(Department of pharmacy,the First Affiliated Hospital of Shihezi University,Xinjiang Shihezi,832008;Department of Obstetrics,the First Affiliated Hospital of Shihezi University,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学第一附属医院药学部,新疆石河子832008 [2]石河子大学第一附属医院产科,新疆石河子832008

出　　处：《农垦医学》2024年第4期297-301,共5页Journal of Nongken Medicine

摘　　要：目的:了解冠心病经皮冠脉介入(PCI)术患者CYP2C19基因多态性分布及个体化抗血小板治疗方案的选择,分析基因检测结果指导个体化抗血小板治疗中医生按照指南制定抗血小板方案的依从性。方法:以2021年1月至2021年12月期间就诊于心血管内科336名急性冠脉综合征且行PCI术及CYP2C19基因多态性检测的患者为研究对象。收集患者的一般临床资料、CYP2C19基因型、术后抗血小板药物的使用情况,分析医生是否按照CYP2C19基因型制定个体化抗血小板治疗方案。结果:CYP2C19快代谢型患者150例(占44.64%)、中间代谢型152例(占45.24%)、慢代谢型34例(占10.12%)。快代谢型有76例(50.67%)患者采用氯吡格雷75 mgqd联合方案,有74例(49.33%)患者采用替格瑞洛90 mgbid联合方案;中间代谢型有64例(42.1%)患者采用氯吡格雷75 mgqd联合方案,88例(57.89%)患者采用替格瑞洛90 mgbid联合方案;慢代谢型有10例(29.41%)患者采用氯吡格雷75 mgqd联合方案,24例(70.59%)患者采用替格瑞洛90 mgbid联合方案。结论:在中、慢代谢型患者中医生根据CYP2C19检测结果制定抗血小板方案的指南依从性较差,应加强用药指导,促进临床合理用药。Objective:Objective to investigate the distribution of CYP2C19 gene polymorphism and the choice of individualized antiplatelet therapy in patients with coronary heart disease undergoing percutaneous coronary intervention(PCI),and to analyze the compliance of doctors in formulating antiplatelet therapy according to the guidelines.Method:A total of 336 patients with acute coronary syndrome who underwent PCI and CYP2C19 gene polymorphism testing in the cardiovascular department between January 2021 and December 2021 were selected as the study subjects.Collect general clinical data of patients,CYP2C19 genotype,and postoperative use of antiplatelet drugs,Analyze whether doctors develop personalized antiplatelet therapy plans based on CYP2C19 genotype.Result:There were 150 patients with CYP2C19 fast metabolism type(44.64%),152 patients with intermediate metabolism type(45.24%),and 34 patients with slow metabolism type(10.12%).76 cases(50.67%)of patients with fast metabolism type were treated with clopidogrel 75mgqd combined regimen,and 74 cases(49.33%)were treated with ticagrelor 90mgbid combined regimen.64 patients(42.1%)of intermediate metabolic type were treated with clopidogrel 75mgqd regimen,and 88 patients(57.89%)were treated with ticagrelor 90mgbid regimen.10 cases(29.41%)of patients with slow metabolism type were treated with clopidogrel 75mgqd combined regimen,and 24 cases(70.59%)were treated with ticagrelor 90mgbid combined regimen.Conclusion:In patients with intermediate metabolism and slow metabolism,doctors have poor compliance with the guidelines for developing antiplatelet regimens based on CYP2C19 test results.Therefore,medication guidance should be strengthened to promote rational clinical use.

关 键 词：经皮冠脉介入 CYP2C19基因多态性 抗血小板治疗 个体化用药 

分 类 号：R541.4[医药卫生—心血管疾病]