急性冠状动脉综合征PCI患者激酶插入结构域受体rs2305948多态性与氯吡格雷抵抗的关系  

Relationship between kinase insert domain receptor rs2305948 polymorphism and clopidogrel resistance in patients with acute coronary syndrome after receiving percutaneous coronary intervention

作　　者：师淼 常建亮 朱星宇 冯倩 陈素艳 李森林 SHI Miao;CHANG Jianliang;ZHU Xingyu;FENG Qian;CHEN Suyan;LI Senlin(Hebei North University,Zhangjiakou,Hebei Province 075000,China)

机构地区：[1]河北北方学院,河北张家口075000 [2]张家口市第一医院心血管内科 [3]张家口市第一医院电生理室

出　　处：《介入放射学杂志》2025年第2期170-175,共6页Journal of Interventional Radiology

基　　金：河北省医学科学研究课题计划项目(20211610);张家口市市级科技计划自筹经费项目(2221124D)。

摘　　要：目的探讨急性冠状动脉综合征经皮冠状动脉介入治疗(PCI)患者激酶插入结构域受体(KDR)rs2305948多态性与氯吡格雷抵抗(CR)的关系。方法选取2022年9月至2023年9月张家口市第一医院收治的468例急性冠状动脉综合征患者为研究对象。所有患者均接受PCI治疗,术后服用氯吡格雷。统计CR发生情况,分析影响PCI患者CR发生的因素,KDR rs2305948多态性预测PCI患者发生CR的价值。结果468例急性冠状动脉综合征患者中有116例(24.79%)发生CR。Logistic回归分析结果显示,高密度脂蛋白胆固醇(HDL-C)(95%CI=1.420~8.390,OR=3.452)、血管内皮细胞生长因子受体(VEGFR)-2(95%CI=1.374~8.118,OR=3.340)、KDR rs2305948 T/T基因型(95%CI=1.677~9.905,OR=4.076)和T等位基因(95%CI=1.390~8.207,OR=3.377)是影响PCI患者CR的独立因素(均P<0.05)。受试者工作特征曲线(ROC)分析结果显示,KDR rs2305948 T/T基因型预测PCI患者发生CR的灵敏度、特异度、曲线下面积(AUC)分别为75.86%、70.45%、0.773(95%CI=0.666~0.880)。结论PCI患者发生CR风险高。KDR rs2305948多态性与PCI患者CR相关。KDR rs2305948多态对PCI患者发生CR有一定的预测价值。Objective To investigate the relationship between kinase insert domain receptor(KDR)rs2305948 polymorphism and clopidogrel resistance(CR)in patients with acute coronary syndrome after receiving percutaneous coronary intervention(PCI).Methods A total of 468 patients with acute coronary syndrome,who were admitted to the Zhangjiakou Municipal First Hospital of China from September 2022 to September 2023,were selected as the subjects of study.All patients received PCI treatment and took medication of clopidogrel after the treatment.The occurrence of CR was recorded.The factors influencing the occurrence of CR were analyzed.The clinical significance of KDR rs2305948 polymorphism in predicting CR in patients with acute coronary syndrome after receiving PCI was evaluated.Results Of 468 patients with acute coronary syndrome,116(24.79%)developed CR.Logistic multivariate regression analysis indicated that low-density lipoprotein cholesterol(LDL-C,95%CI=1.420-8.390,OR=3.452),type 2 vascular endothelial growth factor receptor(VEGFR-2,95%CI=1.374-8.118,OR=3.340),KDR rs2305948 T/T genotype(95%CI=1.677-9.905,OR=4.076),and T allele(95%CI=1.390-8.207,OR=3.377)were the independent factors influencing the occurrence of CR in patients with acute coronary syndrome after receiving PCI(all P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity,specificity,and area under ROC curve(AUC)of the T/T genotype of KDR rs2305948 in predicting CR in patients with acute coronary syndrome after receiving PCI were 75.86%,70.45%,and 0.773(95%CI=0.666-0.880)respectively.Conclusion In patients with acute coronary syndrome after receiving PCI,the risk of developing CR is higher.The KDR rs2305948 polymorphism is correlated with CR in patients with acute coronary syndrome after receiving PCI,and it has a certain predictive value for CR.

关 键 词：激酶插入结构域受体 rs2305948 经皮冠状动脉介入治疗 氯吡格雷抵抗 

分 类 号：R543[医药卫生—心血管疾病]