CAJ | 학술논문

目的探讨非心源性TIA患者服用氯吡格雷后短期内缺血性脑卒中复发与CYP2C19基因多态性的关系. 方法对82例初发非心源性TIA患者给予氯吡格雷联合阿司匹林治疗21 d,随后氯吡格雷单药治疗,总疗程90 d. 根据是否复发缺血性脑卒中将其分为卒中复发组与卒中未复发组,通过CYP2C19基因芯片对两组患者的CYP2 C19基因型进行检测. 结果卒中复发组39例,卒中未复发组43例. 两组患者在年龄、性别、高血压、糖尿病、血脂等的差异均无统计学意义(均P>0.05). 卒中未复发组CYP2C19 *1等位基因频率(76.7%)及CYP2C19*1/*1基因型频率(60.5%)显著高于卒中复发组(41.0%, 20.5%)(均P<0. 01). 卒中未复发组CYP2C19*2 等位基因频率(17.4%)及CYP2C19*2/*2基因型频率(2.3%)则显著低于卒中复发组(53.9%, 30.8%)(均P<0.01). 两组间其它等位基因及基因型频率的差异无统计学意义(均P>0.05). 卒中未复发组强代谢型的比例显著高于卒中复发组(P<0.001);而弱代谢型的比例却显著低于卒中复发组(P=0.001);两组间中间代谢型的比例差异无统计学意义(P=0.427). 结论非心源性TIA患者服用氯吡格雷后短期内缺血性脑卒中复发与CYP2C19基因多态性有关.
목적 탐토비심원성TIA환자복용록필격뢰후단기내결혈성뇌졸중복발여CYP2C19기인다태성적관계. 방법 대82례초발비심원성TIA환자급여록필격뢰연합아사필림치료21 d,수후록필격뢰단약치료,총료정90 d. 근거시부복발결혈성뇌졸중장기분위졸중복발조여졸중미복발조,통과CYP2C19기인심편대량조환자적CYP2 C19기인형진행검측. 결과 졸중복발조39례,졸중미복발조43례. 량조환자재년령、성별、고혈압、당뇨병、혈지등적차이균무통계학의의(균P>0.05). 졸중미복발조CYP2C19 *1등위기인빈솔(76.7%)급CYP2C19*1/*1기인형빈솔(60.5%)현저고우졸중복발조(41.0%, 20.5%)(균P<0. 01). 졸중미복발조CYP2C19*2 등위기인빈솔(17.4%)급CYP2C19*2/*2기인형빈솔(2.3%)칙현저저우졸중복발조(53.9%, 30.8%)(균P<0.01). 량조간기타등위기인급기인형빈솔적차이무통계학의의(균P>0.05). 졸중미복발조강대사형적비례현저고우졸중복발조(P<0.001);이약대사형적비례각현저저우졸중복발조(P=0.001);량조간중간대사형적비례차이무통계학의의(P=0.427). 결론 비심원성TIA환자복용록필격뢰후단기내결혈성뇌졸중복발여CYP2C19기인다태성유관.
Objective To investigate the relationship between the recurrence of ischemic stroke in short period after taking clopidogrel and the CYP2C19 gene polymorphisms in non-cardiogenic TIA patients.Methods Eighty-two patients with first onset non-cardiogenic TIA were given 21 d of clopidogrel plus aspirin treatment at first, then only clopidogrel treatment, and the total duration of treatment was 90 d.They were divided into stroke recurrence group and non-stroke recurrence group according to whether the ischemic stroke recurred or not.The genotypes of CYP2C19 were detected with CYP2C19 gene chip.Results Stroke recurrence group was 39 cases, and non-stroke recurrence group was 43 cases.There were no significant differences in age, sex, hypertension, diabetes and blood lipids between the two groups (all P>0.05).The CYP2C19*1 allele and CYP2C19*1/*1 genotype frequencies of the non-stroke recurrence group (76.7%, 60.5%) were significantly higher than those in stroke recurrence group (41.0%, 20.5%)(all P<0.01).The CYP2C19*2 allele and CYP2C19*2/*2 genotype frequencies of the non-stroke recurrence group (17.4%, 2.3%)were significantly lower than those in stroke recurrence group (53.9%, 30.8%)(all P<0.01).The other alleles and genotypes frequencies were no significant differences between the two groups (all P>0.05).Extensive metabolizer proportion of the non-stroke recurrence group was significantly higher than that of the stroke recurrence group ( P<0.001);while poor metabolizer proportion of the non-stroke recurrence group was significantly lower than that of the stroke recurrence group (P=0.001);and the intermediate metabolizer proportions between the two groups were of no difference ( P=0.427) .Conclusion Recurrence of ischemic stroke in short period in patients taking clopidogrel after the first non-cardiogenic TIA is associated with the mutation of CYP2C19 gene.