CAJ | 학술논문

1例76岁男性急性冠状动脉综合征患者行经皮冠状动脉支架置入术后规律口服阿司匹林(0.1g、1次/d)、氯吡格雷(50 mg、1次/d)、阿托伐他汀钙(20 mg、1次/d)和单硝酸异山梨酯(10 mg、2次/d).2个月后突发左侧腰痛伴肉眼血尿.实验室检查:尿隐血(+++),红细胞235个/μl,红细胞19个/高倍视野.泌尿系统超声和肾功能检查未见明显异常.停用氯吡格雷和阿司匹林,并给予对症治疗.2d后患者尿液恢复正常,左侧腰痛明显好转,尿红细胞阴性.细胞色素P450 (CYP)2C19基因多态性检测显示患者携带CYP2C19* 17等位基因,即CYP2C19酶为超快代谢型.继续给予患者阿司匹林等口服治疗,患者未再出现血尿.
1례76세남성급성관상동맥종합정환자행경피관상동맥지가치입술후규률구복아사필림(0.1g、1차/d)、록필격뢰(50 mg、1차/d)、아탁벌타정개(20 mg、1차/d)화단초산이산리지(10 mg、2차/d).2개월후돌발좌측요통반육안혈뇨.실험실검사:뇨은혈(+++),홍세포235개/μl,홍세포19개/고배시야.비뇨계통초성화신공능검사미견명현이상.정용록필격뢰화아사필림,병급여대증치료.2d후환자뇨액회복정상,좌측요통명현호전,뇨홍세포음성.세포색소P450 (CYP)2C19기인다태성검측현시환자휴대CYP2C19* 17등위기인,즉CYP2C19매위초쾌대사형.계속급여환자아사필림등구복치료,환자미재출현혈뇨.
A 76-year-old male patient with acute coronary syndrome received regularly aspirin (0.1 g once daily),clopidogrel (50 mg once daily),atorvastatin calcium (20 mg once daily),and isosorbide mononitrate (10 mg twice daily) by mouth after undergoing percutaneous coronary intervention.He suffered from left lumbago with gross hematuria after 2 months of treatments.Laboratory tests showed the following values:urine occult blood(+++),235 red blood cells per microlitre and 17 red blood cells per high power field.Urinary system ultrasonography and renal function detection showed no abnormalities.Aspirin and clopidogel were withdrawn and the symptomatic treatments were given.Two days later,the patient's urine recovered to normal,his left lumbago was alleviated,and the red blood cell in his urine was negative.Gene polymorphism detection of cytochrome P-450 (CYP)2C19 showed that the patient carried CYP2C19 *17(CT) allele and CYP2C19 enzyme had ultra rapid metabolism.Aspirin was given orally and the hematuria did not appear again.