冠心病患者CYP2C19基因型分布特点及其基因型指导PCI术后抗血小板治疗的效果

发布时间：2018-01-05 18:30

本文关键词：冠心病患者CYP2C19基因型分布特点及其基因型指导PCI术后抗血小板治疗的效果　出处：《心脏杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨中国西北地区汉族部分冠心病患者CYP2C19基因型分布特点,依据基因检测指导PCI术后氯吡格雷抗血小板治疗。方法 1入选2013年1月~7月在西京医院心内科诊断冠心病患者且行基因型检测共2 117例,根据不同等位基因功能缺失分为快代谢基因型(*1/*1);中间代谢型CYP2C19(*1/*2)、(*1/*3);慢代谢型CYP2C19(*2/*2)、(*2/*3)、(*3/*3);2选择上述临床资料完整的急性冠脉综合征(ACS)患者共864例,于术后1,3,6,9和12个月随访两组间主要不良心血管事件(MACE)发生情况。结果 1检测入选的2 117例患者基因型结果显示,快代谢型885例,发生率41.80%,中间代谢型971例,发生率45.86%,慢代谢型261例,发生率12.32%;对入组患者一般临床资料统计分析,各组基因型在性别、不同地区、不同年龄分布的比较均存在差异,具有统计学意义。2快代谢型(正常代谢组)患者346例,中间代谢和慢代谢型(弱代谢组)患者461例,记录随访结果两组间MACE发生率比为〔7.8%(27/346)vs.5.4%(25/461)〕,两组间无统计学差异。结论 1入选患者基因型突变以*1/*2为主,各组在性别、地区、年龄组分布的比较均存在差异;2按患者CYP2C19基因型调整氯吡格雷用量进行抗血小板治疗是有效的。
[Abstract]:Objective to investigate the distribution of CYP2C19 genotypes in some patients with coronary heart disease (CHD) in Northwest China. Methods 2117 patients with coronary heart disease were diagnosed in Xijing Hospital from January 2013 to July. According to the functional deletions of different alleles, the fast metabolic genotypes were divided into 1 / 1 / 1 / 1. The intermediate metabolic type CYP2C19 is 1 / 2 / 1 / 1 / 1 / 2 / 1 / 3 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 /. Slow metabolic type CYP2C19 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2. 2 A total of 864 patients with acute coronary syndrome (ACSS) with complete clinical data were selected. Results 1 the genotypes of 2 117 selected patients were detected and 885 cases of fast metabolic type were detected. The incidence rate was 41.80 meters, 971 cases were intermediate metabolic type, the incidence rate was 45.86 and 261 cases were slow metabolic type, the incidence rate was 12.32. Statistical analysis of the general clinical data of the patients into the group showed that there were differences in the gender, different regions and different age distribution of the genotypes in each group. There were 346 cases of fast metabolic type (normal metabolism group) and 461 cases of intermediate and slow metabolic type (weak metabolism group). The rate of MACE incidence between the two groups was recorded as 7.8R = 27 / 346vs.5.4 / 25 / 461). Conclusion (1) the genotype mutation of the selected patients was mainly 1 / 2, and there were differences in the distribution of gender, region and age group among the three groups. 2 it is effective to adjust clopidogrel dosage according to CYP2C19 genotype.
【作者单位】：第四军医大学西京医院心内科;西安一四一医院心内科;
【分类号】：R541.4
【正文快照】： 网络出版地址:http://www.cnki.net/kcms/detail/61.1268.R.20160517.1451.022.html冠状动脉粥样硬化性心脏病的发病率日益增高,并且出现年轻化的趋势,严重危害人类健康。经皮冠状动脉介入(percutaneous coronary intervention,PCI)术是目前治疗冠心病的重要手段。氯吡格雷是

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