CAJ | 학술논문

目的探讨择期行冠状动脉介入治疗术（ PCI ）的患者服用氯吡格雷治疗的反应性与细胞色素P450（CYP）2C19基因多态性关系。方法选取择期行PCI治疗的冠心病患者112例，根据光学法血小板聚集率（PAgT）结果分为氯吡格雷抵抗（ CR）组（52例）和非CR组（60例）；并提取患者外周血基因组DNA，将提取后的总DNA进行PCR扩增，PCR-LDR检测CYP2C19*2、CYP2C19*3和CYP2C19*17三个多态性位点；所有数据应用SPSS16．0软件进行统计分析。结果 CR组血小板最大聚集率（MPA）值显著高于非CR组（P＜0．01），而血小板数量、药物使用史均无统计学差异（P均＞0．05）；CR组CYP2C19*2出现突变的比例显著高于非CR组（P＜0．01），CR组和非CR组CYP2C19*3等位基因改变没有统计学差异（P＞0．05），入组患者中未发现CYP2C19*17等位基因的改变。结论冠心病患者PCI手术后CR发生率与CYP2C19*2基因多态性有密切关系，CYP2C19的基因型检测氯吡格雷个体著用药具有指导意义。
목적탐토택기행관상동맥개입치료술（ PCI ）적환자복용록필격뢰치료적반응성여세포색소P450（CYP）2C19기인다태성관계。방법선취택기행PCI치료적관심병환자112례，근거광학법혈소판취집솔（PAgT）결과분위록필격뢰저항（ CR）조（52례）화비CR조（60례）；병제취환자외주혈기인조DNA，장제취후적총DNA진행PCR확증，PCR-LDR검측CYP2C19*2、CYP2C19*3화CYP2C19*17삼개다태성위점；소유수거응용SPSS16．0연건진행통계분석。결과 CR조혈소판최대취집솔（MPA）치현저고우비CR조（P＜0．01），이혈소판수량、약물사용사균무통계학차이（P균＞0．05）；CR조CYP2C19*2출현돌변적비례현저고우비CR조（P＜0．01），CR조화비CR조CYP2C19*3등위기인개변몰유통계학차이（P＞0．05），입조환자중미발현CYP2C19*17등위기인적개변。결론관심병환자PCI수술후CR발생솔여CYP2C19*2기인다태성유밀절관계，CYP2C19적기인형검측록필격뢰개체저용약구유지도의의。
Objective To investigate the relationship between cytochrome P 450 (CYP)2C19 genetic polymorphism and reaction of clopidogrel in patients with coronary heart disease after percutaneous coronary intervention ( PCI) .Methods The peripheral blood samples of 112 patients with coronary heart disease and treated with PCI were recruited ,the genomic DNA was extracted and amplified by PCR ,and genetic polymor-phisms of CYP2C19(CYP2C19*2、CYP2C19*3 and CYP2C19*17)were identified by ligase detection re-action.The subjects were divided into two groups according to the results of platelet aggregation rate measured with LTA.All data was analyzed by SPSS 16.0.Results The MPA value of CR group is significantly higher than the patients without CR group(P<0.01).There were no significant difference in the counts of platelet and history of drugs(P>0.05),Of all the patients did not find CYP2C19*17 alleles of change.Conclusion The genetic polymorphism of CYP 2 C19*2 was associated with clopidogrel resistance in patients with coro-nary heart disease after PCI ,Genotyping of CYP2C19 will be helpfui in guiding individualized medication of clopidogrel .