CAJ | 학술논문

目的探讨汉族冠状动脉粥样硬化性心脏病患者细胞色素P450氧化酶系统(CYP2C19)基因多态性与氯吡格雷药物临床疗效的关系. 方法 176例经皮冠状动脉介入治疗(PCI)术后,接受阿司匹林+氯吡格雷双联抗血小板治疗,运用PCR-RFLP方法进行CYP2C19*2,*3两种突变等位基因检测,根据等位基因功能缺失,分析CYP2C19不同代谢基因型与心血管终点事件的相关性. 结果 CYP2C19*2和*3的等位基因频率分别为34.38％和5.97％,慢代谢基因型(*2/*2,*2/*3,*3/*3)占14.20％.随访中11例患者急性冠脉综合征再发,1例出现脑梗死,4例患者出现支架内血栓,心血管终点事件的发生率为9.09％.慢代谢基因型组心血管终点事件的发生率为16.00％,与非慢代谢基因型组(7.95％)比较差异无统计学意义(x2=1.683,P=0.195).结论中国汉族冠心病患者CYP2C19慢代谢基因型频率高于高加索人种,但心血管终点事件的发生率并无明显升高.
목적 탐토한족관상동맥죽양경화성심장병환자세포색소P450양화매계통(CYP2C19)기인다태성여록필격뢰약물림상료효적관계. 방법 176례경피관상동맥개입치료(PCI)술후,접수아사필림+록필격뢰쌍련항혈소판치료,운용PCR-RFLP방법진행CYP2C19*2,*3량충돌변등위기인검측,근거등위기인공능결실,분석CYP2C19불동대사기인형여심혈관종점사건적상관성. 결과 CYP2C19*2화*3적등위기인빈솔분별위34.38％화5.97％,만대사기인형(*2/*2,*2/*3,*3/*3)점14.20％.수방중11례환자급성관맥종합정재발,1례출현뇌경사,4례환자출현지가내혈전,심혈관종점사건적발생솔위9.09％.만대사기인형조심혈관종점사건적발생솔위16.00％,여비만대사기인형조(7.95％)비교차이무통계학의의(x2=1.683,P=0.195).결론 중국한족관심병환자CYP2C19만대사기인형빈솔고우고가색인충,단심혈관종점사건적발생솔병무명현승고.
Objective To investigate the association between CYP2C19 polymorphisms and efficacy of clopidogrel in Chinese Han patients with coronary atherosclerotic heart disease.Methods A total of 176 Chinese Han patients who underwent percutaneous coronary intervention and were treated with dual antiplatelet therapy with aspirin and clopidogrel were enrolled.Polymorphisms of CYP2C19 * 2,* 3 were measured by PCR-restriction fragment length polymorphism (PCR RFLP).The correlation between the genetic variants and cardiovascular events was analyzed.Results In the 176 patients,the allele frequencies of CYP2C19 * 2 and * 3 were 34.38％ and 5.97％ respectively,the percent of patients with poor metabolizer genotypes (* 2/* 2,* 2/* 3,* 3/* 3) was 14.20％.Among the 176 patients,11 patients reoccured acute coronary syndrome,1 patient suffered from stroke,and 4 patients had stent thrombosis.The incidence of cardiovascular events was 9.09 ％.Thecumulative incidence of cardiovascular events had no significant differences between poor metabolizer genotype carriers and extensive and intermediate metabolizer genotype carriers (16.00％ vs.7.95％,x2 =1.683,P=0.195).Conclusions The frequencies of CYP2C19 poor metabolizer genotypes are higher in Chinese Han population than in Caucasians,but the incidence of cardiovascular events in Chinese Han population is not increased.