不同族群CYP2C19基因多态性与凝血功能相关性分析

发布时间：2018-04-14 02:23

本文选题：氯吡格雷抵抗 + CYP2C19　；参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：通过确定CYP2C19基因型及在维吾尔族、哈萨克族、汉族人群中的等位基因分布特征,明确基因多态性与民族差异性之间的关系,根据凝血功能检验结果的不同,得出不同CYP2C19等位基因对氯吡格雷临床疗效的关系,从而达到协助调整用药剂量,提高药物疗效,减少药物毒副作用的目的。方法：选取新疆医科大学一附院干内二科住院冠心病患者520例,采用聚合酶链-限制性片段长度多态性方法分析CYP2C19基因多态性,了解基因型分布在3个民族间的差异。同时从中选取77例无亲缘关系的维吾尔族冠心病患者,均给予75mg氯吡格雷常规剂量每日一次口服,一定时间后观察其静脉血纤维蛋白原、凝血酶原时间(PT)、部分凝血酶原时间(APTT)结果。根据凝血功能检验结果的不同,得出不同CYP2C19等位基因与氯吡格雷临床疗效对凝血功能影响的关系。结果：检测到CYP2C19的6个基因型在维吾尔族、哈萨克族、汉族间分布差异显著(P0.05)。同时根据对77例维吾尔族患者等位基因不同进行分组。然而CYP2C19*1,CYP2C19*2,CYP2C19*3各组之间纤维蛋白原、凝血酶原时间、部分凝血酶原时间之间无明显差异性,无统计学意义。结论：在维吾尔族、哈萨克族、汉族人群中,CYP2C19的基因型分布有显著差异,可指导临床个体化用药。通过对77例维吾尔族冠心病患者的凝血功能指标检测发现等位基因*2、等位基因*3对凝血功能的影响无明显差异性,无统计学意义。
[Abstract]:Objective: to determine the relationship between genetic polymorphisms and ethnic differences by determining the genotypes of CYP2C19 and the distribution of alleles in Uygur, Kazak and Han populations, according to the different results of coagulation function test.The relationship between the clinical efficacy of clopidogrel with different CYP2C19 alleles was obtained, so as to help adjust the dosage, improve the efficacy and reduce the side effects of clopidogrel.Methods: the polymorphism of CYP2C19 gene was analyzed by polymerase chain-restriction fragment length polymorphism (PCR) in 520 patients with coronary heart disease (CHD) in the first affiliated Hospital of Xinjiang Medical University.77 unrelated Uygur patients with coronary heart disease were given 75mg clopidogrel once a day, and their venous fibrinogen was observed after a certain time.Prothrombin time (PTT) and partial prothrombin time (APTT).According to the different results of clotting function test, the relationship between different CYP2C19 alleles and clopidogrel clinical effect on coagulation function was obtained.Results: six genotypes of CYP2C19 were detected in Uygur, Kazak and Han nationality.At the same time, the alleles of 77 Uygur patients were divided into groups.However, there was no significant difference in fibrinogen, prothrombin time and partial prothrombin time between the three groups.Conclusion: the genotype distribution of CYP2C19 in Uygur, Kazak and Han populations is significantly different, and it can be used as a guide for clinical individualized drug use.The coagulation function indexes of 77 patients with coronary heart disease in Uygur nationality were detected. The results showed that allele 2 and allele 3 had no significant difference in coagulation function and had no statistical significance.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4

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