武警医学
武警醫學
무경의학
MEDICAL JOURNAL OF THE CHINESE PEOPLE'S ARMED POLICE FORCES
2015年
6期
580-583,586
,共5页
CYP2C19基因多态性%ADP诱导的血小板抑制率%冠心病
CYP2C19基因多態性%ADP誘導的血小闆抑製率%冠心病
CYP2C19기인다태성%ADP유도적혈소판억제솔%관심병
CYP2C19 gene polymorphism%the ADP-induced platelet inhibition rate%coronary artery disease
目的：探讨冠心病（ coronary artery disease，CAD）介入术后氯吡格雷低反应发生与CYP2C19基因多态性的关系。方法选取武警总医院心内科行经皮冠状动脉介入治疗（ percutaneous coronary intervention，PCI ）患者200例，术后给予阿司匹林和氯吡格雷双联抗血小板药，并经血栓弹力图检测二磷酸腺苷（ adenosine diphosphate， ADP）诱导的血小板抑制率，按ADP诱导的血小板抑制率是否小于30％，将患者分为氯吡格雷低反应组和氯吡格雷敏感组；同时采用基因芯片技术检测CYP2C19基因多态性，判断对氯吡格雷的反应性的影响。结果 CYP2C19*1／*1与CYP2C19*1／*2、CYP2C19*1／*1与CYP2C19*2／*2、快与中间代谢型比较ADP的抑制率有统计学差异；共79例（39．5％）发生氯吡格雷低反应。氯吡格雷敏感组快代谢型者（基因型*1／*1）多于低反应组（P＝0．013），氯吡格雷低反应组中慢代谢型较多（P＝0．013），差异均有统计学意义。其他代谢型间比较无差异。结论冠心病PCI术后氯吡格雷低反应与CYP2C19基因多态性相关，携带中慢代谢型基因者发生氯吡格雷低反应较多。
目的：探討冠心病（ coronary artery disease，CAD）介入術後氯吡格雷低反應髮生與CYP2C19基因多態性的關繫。方法選取武警總醫院心內科行經皮冠狀動脈介入治療（ percutaneous coronary intervention，PCI ）患者200例，術後給予阿司匹林和氯吡格雷雙聯抗血小闆藥，併經血栓彈力圖檢測二燐痠腺苷（ adenosine diphosphate， ADP）誘導的血小闆抑製率，按ADP誘導的血小闆抑製率是否小于30％，將患者分為氯吡格雷低反應組和氯吡格雷敏感組；同時採用基因芯片技術檢測CYP2C19基因多態性，判斷對氯吡格雷的反應性的影響。結果 CYP2C19*1／*1與CYP2C19*1／*2、CYP2C19*1／*1與CYP2C19*2／*2、快與中間代謝型比較ADP的抑製率有統計學差異；共79例（39．5％）髮生氯吡格雷低反應。氯吡格雷敏感組快代謝型者（基因型*1／*1）多于低反應組（P＝0．013），氯吡格雷低反應組中慢代謝型較多（P＝0．013），差異均有統計學意義。其他代謝型間比較無差異。結論冠心病PCI術後氯吡格雷低反應與CYP2C19基因多態性相關，攜帶中慢代謝型基因者髮生氯吡格雷低反應較多。
목적：탐토관심병（ coronary artery disease，CAD）개입술후록필격뢰저반응발생여CYP2C19기인다태성적관계。방법선취무경총의원심내과행경피관상동맥개입치료（ percutaneous coronary intervention，PCI ）환자200례，술후급여아사필림화록필격뢰쌍련항혈소판약，병경혈전탄력도검측이린산선감（ adenosine diphosphate， ADP）유도적혈소판억제솔，안ADP유도적혈소판억제솔시부소우30％，장환자분위록필격뢰저반응조화록필격뢰민감조；동시채용기인심편기술검측CYP2C19기인다태성，판단대록필격뢰적반응성적영향。결과 CYP2C19*1／*1여CYP2C19*1／*2、CYP2C19*1／*1여CYP2C19*2／*2、쾌여중간대사형비교ADP적억제솔유통계학차이；공79례（39．5％）발생록필격뢰저반응。록필격뢰민감조쾌대사형자（기인형*1／*1）다우저반응조（P＝0．013），록필격뢰저반응조중만대사형교다（P＝0．013），차이균유통계학의의。기타대사형간비교무차이。결론관심병PCI술후록필격뢰저반응여CYP2C19기인다태성상관，휴대중만대사형기인자발생록필격뢰저반응교다。
Objective To study the correlation between clopidogrel low respone and CYP2C19 gene polymorphism in coronary artery disease( CAD) patients after percutaneous coronary intervention( PCI) .Methods A total of 200 patients with CAD admitted to this hospital from October 2013 to October 2014 were included in this study, and treated with dual antiplatelet drugs, aspirin and clopi-dogrel after PCI.The clopidogrel response was judged by depending on the ADP-induced platelet inhibition rate tested by thromboelas-togram ( TEG) .In this study the ADP-induced platelet inhibition rate less than 30% was defined as clopidogrel low respone and the gene chip detection technology was used to detect the genotyes of CYP2C19 to further explore its effect on clopidogrel respone. Results In these 200 patients, the ADP-induced platelet inhibition rate was statistically significantly different between patients carry-ing CYP2C19*1/*1 and CYP2C19*1/*2、CYP2C19*1/*1 and CYP2C19*2/*2、extensive and intermediate metabolizers.The total occurrence of clopidogrel low response was 39.5%(79 patients) .There was significant difference between clopidogrel low re-spone and CYP2C19 genotyes、metabolizers, indicating that more carriers with extensive metabolizer (CYP2C19*1/*1) in the clopi-dogrel response group(P=0.013), more carriers with intermediate or poor metabolizers in the clopidogrel low response group(P=0.013) .Conclusions There is correlation between clopidogrel low respone and CYP2C19 gene polymorphism in patients with CAD after PCI, more carriers with intermediate or poor metabolizers in the clopidogrel low response group.
