检验医学与临床
檢驗醫學與臨床
검험의학여림상
JOURNAL OF LABORATORY MEDICINE AND CLINICAL SCIENCES
2015年
4期
433-435
,共3页
吴薇%韩瑞玲%王丽岳%李艳
吳薇%韓瑞玲%王麗嶽%李豔
오미%한서령%왕려악%리염
氯吡格雷%细胞色素氧化酶P450 2C19%DNA测序
氯吡格雷%細胞色素氧化酶P450 2C19%DNA測序
록필격뢰%세포색소양화매P450 2C19%DNA측서
clopidogrel%cytochrome P450 2C19%DNA sequencing
目的:评估DNA测序法检测细胞色素氧化酶P4502C19(CYP2C19)多态性以指导氯吡格雷临床用药。方法选取2010年11月至2013年11月武汉大学人民医院心血管内科诊断为急性冠状动脉综合征,并首次接受经皮冠状动脉介入治疗术(PCI)的140例患者为研究对象,随机分为试验组及对照组各70例。试验组采集外周血标本并提取基因组DNA ,根据已知的CYP2C19基因序列,设计针对CYP2C19*2、CYP2C19*3位点的特异性引物,聚合酶链反应扩增包含 CYP2C19基因多态性位点的 DNA 片段;并以 DNA 测序法进行鉴定,分析不同CYP2C19基因型在试验组患者中的分布频率。对照组患者使用氯吡格雷药物但未检测相关基因。比较两组患者随访过程中发生冠状动脉血栓事件的差异。结果 DNA测序结果显示,试验组中共有4种基因型组合被检测到:*1/*1(636GG ,681GG)、*1/*2(636GG ,681GA)、*2/*2(636GG ,681AA)、*1/*3(636GA ,681GG),分布频率分别为33例(47.1%)、29例(41.4%)、4例(5.7%)、4例(5.7%),而*3/*3(636AA ,681GG )和*2/*3(636GA ,681GA )未检测到。经基因型指导氯吡格雷用药的试验组患者发生支架冠状动脉血栓事件的比例为0.0%,明显低于对照组的7.1%,差异有统计学意义(P<0.05)。结论基因型指导氯吡格雷用药有助于患者用药剂量的调整,可降低冠状动脉血栓事件的发生率。
目的:評估DNA測序法檢測細胞色素氧化酶P4502C19(CYP2C19)多態性以指導氯吡格雷臨床用藥。方法選取2010年11月至2013年11月武漢大學人民醫院心血管內科診斷為急性冠狀動脈綜閤徵,併首次接受經皮冠狀動脈介入治療術(PCI)的140例患者為研究對象,隨機分為試驗組及對照組各70例。試驗組採集外週血標本併提取基因組DNA ,根據已知的CYP2C19基因序列,設計針對CYP2C19*2、CYP2C19*3位點的特異性引物,聚閤酶鏈反應擴增包含 CYP2C19基因多態性位點的 DNA 片段;併以 DNA 測序法進行鑒定,分析不同CYP2C19基因型在試驗組患者中的分佈頻率。對照組患者使用氯吡格雷藥物但未檢測相關基因。比較兩組患者隨訪過程中髮生冠狀動脈血栓事件的差異。結果 DNA測序結果顯示,試驗組中共有4種基因型組閤被檢測到:*1/*1(636GG ,681GG)、*1/*2(636GG ,681GA)、*2/*2(636GG ,681AA)、*1/*3(636GA ,681GG),分佈頻率分彆為33例(47.1%)、29例(41.4%)、4例(5.7%)、4例(5.7%),而*3/*3(636AA ,681GG )和*2/*3(636GA ,681GA )未檢測到。經基因型指導氯吡格雷用藥的試驗組患者髮生支架冠狀動脈血栓事件的比例為0.0%,明顯低于對照組的7.1%,差異有統計學意義(P<0.05)。結論基因型指導氯吡格雷用藥有助于患者用藥劑量的調整,可降低冠狀動脈血栓事件的髮生率。
목적:평고DNA측서법검측세포색소양화매P4502C19(CYP2C19)다태성이지도록필격뢰림상용약。방법선취2010년11월지2013년11월무한대학인민의원심혈관내과진단위급성관상동맥종합정,병수차접수경피관상동맥개입치료술(PCI)적140례환자위연구대상,수궤분위시험조급대조조각70례。시험조채집외주혈표본병제취기인조DNA ,근거이지적CYP2C19기인서렬,설계침대CYP2C19*2、CYP2C19*3위점적특이성인물,취합매련반응확증포함 CYP2C19기인다태성위점적 DNA 편단;병이 DNA 측서법진행감정,분석불동CYP2C19기인형재시험조환자중적분포빈솔。대조조환자사용록필격뢰약물단미검측상관기인。비교량조환자수방과정중발생관상동맥혈전사건적차이。결과 DNA측서결과현시,시험조중공유4충기인형조합피검측도:*1/*1(636GG ,681GG)、*1/*2(636GG ,681GA)、*2/*2(636GG ,681AA)、*1/*3(636GA ,681GG),분포빈솔분별위33례(47.1%)、29례(41.4%)、4례(5.7%)、4례(5.7%),이*3/*3(636AA ,681GG )화*2/*3(636GA ,681GA )미검측도。경기인형지도록필격뢰용약적시험조환자발생지가관상동맥혈전사건적비례위0.0%,명현저우대조조적7.1%,차이유통계학의의(P<0.05)。결론기인형지도록필격뢰용약유조우환자용약제량적조정,가강저관상동맥혈전사건적발생솔。
Objective To evaluate the clinical application value of detectiing Cytochrome P 450 2C19 (CYP2C19) polymorphisms by DNA sequencing in clopidogrel application .Methods From November 2010 to No‐vember 2013 ,a total of 140 blood samples were randomly collected in patients with acute coronary syndrome and trea‐ted with percutaneous coronary intervention (PCI) for the first time in the department of cardiology in People′s Hos‐pital of Wuhan University .Aaa the patients were divided as control group and study group randomly ,70 patients in each group .According to known gene sequences of CYP2C19 ,specific primers were synthesized to genotype the CYP2C19*2 and CYP2C19*3 alleles through polymerase chain reaction (PCR) amplification and DNA sequencing . Meanwhile ,the distribution of these alleles in the study group was analyzed .The control group didn′t do genotype but use clopidogrel .The incidence rates of coronary artery thrombosis in the process of follow‐up between the two groups was compared .Results DNA sequencing results showed that 4 kinds of gene type were detected including *1/*1 (636GG ,681GG) ,*1/*2(636GG ,681GA) ,*2/*2(636GG ,681AA) and *1/*3(636GA ,681GG) .The distribu‐tion rates of them were 47 .1% ,41 .4% ,5 .7% and 5 .7% respectively .However ,*3/*3(636AA ,681GG) and *2/*3(636GA ,681GA ) were not found .Besides ,the incidence rate of coronary artery thrombosis in the study group (0 .0% ) was significant lower than that of the control group (7 .1% )(P<0 .05) .Conclusion It is help to use the de‐tection of CYP2C19 polymorphism by DNA sequencing guiding the dosage of clopidogrel ,and could reduce the occur‐rence of coronary artery thrombosis .