CAJ | 학술논문

目的：研究多重耐药基因（MDR1）及细胞色素P450酶2C19（CYP2C19）基因多态性对急性冠脉综合征（ ACS）患者经皮冠状动脉介入（ PCI）术后氯吡格雷疗效的影响。方法根据所测定的血栓弹力图MAADP结果，将进行PCI治疗的冠心病患者分为3组：A（MAADP ＞47）组、B（31≤MAADP≤47）组、C（MAADP ＜31）组；分别用基因芯片法和测序法，检测CYP2C19、MDR1基因多态性，比较不同组间基因多态性分布情况。结果各组患者在MDR1基因多态性未见明显差异（P＞0.05），CYP2C19慢代谢基因型患者比例在 A 组明显高于另2组（P＜0.05）。结论 CYP2C19基因多态性可以影响氯吡格雷的抗凝效果。
목적：연구다중내약기인（MDR1）급세포색소P450매2C19（CYP2C19）기인다태성대급성관맥종합정（ ACS）환자경피관상동맥개입（ PCI）술후록필격뢰료효적영향。방법근거소측정적혈전탄력도MAADP결과，장진행PCI치료적관심병환자분위3조：A（MAADP ＞47）조、B（31≤MAADP≤47）조、C（MAADP ＜31）조；분별용기인심편법화측서법，검측CYP2C19、MDR1기인다태성，비교불동조간기인다태성분포정황。결과각조환자재MDR1기인다태성미견명현차이（P＞0.05），CYP2C19만대사기인형환자비례재 A 조명현고우령2조（P＜0.05）。결론 CYP2C19기인다태성가이영향록필격뢰적항응효과。
Objective To study the relationship between multidrug re-sistance gene(MDR1)and cytochrome P450 2C19(CYP2C19)gene poly-morphisms and the effect of clopidogrel in patients with acute coronary syndrome ( ACS ) after undergoing percutaneous coronary intervention ( PCI ) .Methods The patients with ACS who were undergoing PCI were divided into three groups according to the result of MA ADP which tests by thromboelastogram ( TEG).Group A consists of patients with MA ADP >47, group B consists of patients with 31≤MAADP≤47 and group C con-sists of patients with MA ADP <31, respectively.The genotype of CYP2C19 is decided by gene chips hybridization and the genotype of MDR1 is decided by gene sequencing.Then the distribution of gene poly-morphism between were compared with different groups.Results There were no significantly differences among three groups in different genotype of MDR1( P>0.05 ).The proportion of patients with poor metabolism of CYP2C19 in group A was higher than the other two groups significantly ( P<0.05).Conclusion CYP2C19 gene polymorphisms affect the an-ticoagulant effect of clopidogrel.