CYP2C19基因多态性与症状性颅内动脉狭窄患者氯吡格雷反应性及早期神经功能恶化的相关性

发布时间：2018-07-23 19:59

【摘要】：【目的】探讨CYP2C19基因多态性与症状性颅内动脉狭窄患者氯吡格雷反应性及早期神经功能恶化的相关性。【方法】连续性收集症状性颅内动脉狭窄患者116例,根据是否出现早期神经功能恶化分为恶化组22例与非恶化组94例,记录基线资料,检测CYP2C19基因型,口服氯吡格雷后第8天测定血小板最大聚集率,比较两组CYP2C19基因多态性与氯吡格雷反应性。【结果】恶化组患者合并糖尿病、既往短暂性脑缺血发作(TIA)史明显高于非恶化组(P0.05);恶化组CYP2C19*2位点AA基因型、A等位基因频率明显高于非恶化组,GG基因型频率明显低于非恶化组(27.27%vs 2.13%,50.00%vs 14.84%,27.27%vs 72.34%)(P0.01);弱代谢型患者血小板最大聚集率明显高于快代谢型、中间代谢型(P0.01,P0.05),中间代谢型血小板最大聚集率明显高于快代谢型(P0.01);恶化组CYP2C19基因分型快代谢型明显低于非恶化组,弱代谢型明显高于非恶化组(22.73%vs 65.96%,36.36%vs 5.32%)(P0.01);发生氯吡格雷抵抗59.09%明显高于非恶化组28.72%(P0.05)。【结论】CYP2C19基因多态性与症状性颅内动脉狭窄患者氯吡格雷反应性及早期神经功能恶化有关。
[Abstract]:[objective] to investigate the association of CYP2C19 gene polymorphism with clopidogrel reactivity and early neurological deterioration in patients with symptomatic intracranial artery stenosis. According to whether or not there was early deterioration of nerve function, the patients were divided into two groups, 22 cases in the worsening group and 94 cases in the non-worsening group. Baseline data were recorded, CYP2C19 genotypes were detected, and the maximal platelet aggregation rate was measured 8 days after oral clopidogrel. CYP2C19 gene polymorphism and clopidogrel reactivity were compared between the two groups. The frequency of AA genotype A allele was significantly higher in the exacerbation group than in the non-worsening group (P0.05), and the frequency of the AA genotype A allele in the worsening group was significantly lower than that in the non-worsening group (27.27%vs 2.13 + 50.00vs 14.84 + 27.27 vs 72.34%) (P0.01), and in the weakly metabolic type patients, the frequency of the AA genotype was significantly higher than that of the non-worsening group (P0.01). The maximal aggregation rate of platelet was significantly higher than that of fast metabolic type. The maximal platelet aggregation rate of the intermediate metabolic type was significantly higher than that of the fast metabolic type (P0.01), and the CYP2C19 genotyping of the deteriorated group was significantly lower than that of the non-deteriorated group. The weak metabolic type was significantly higher than that in the non-deterioration group (22.73%vs 65.96 vs 5.32%), and clopidogrel resistance in 59.09% was significantly higher than that in the non-worsening group (P 0.05). [conclusion] the polymorphism of CYP2C19 gene was associated with clopidogrel reactivity and early deterioration of nerve function in patients with symptomatic intracranial artery stenosis.
【作者单位】：苏州大学附属第一医院神经内科;
【基金】：国家自然科学基金青年基金(81601011)
【分类号】：R743

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