【摘要】 检测拟行经皮冠状动脉介入术治疗的冠心病患者的CYP2C19基因多态性,考察相关的临床危险因素,评价CYP2C19基因多态性对服用氯吡格雷冠心病患者的影响,为临床用药提供科学依据。选取2015年1月~2015年9月在笔者所在医院心内科、CCU科室拟行经皮冠状动脉介入术治疗的冠心病患者共171例,患者均给予300mg氯吡格雷为负荷剂量,75mg氯吡格雷为维持剂量合并阿司匹林抗血小板治疗。检测细胞色素P450系统药物代谢酶CYP2C19的基因型,分为快代谢型(*1/*1),中间代谢型(*1/*2、*1/*3),慢代谢型(*2/*2、*2/*3、*3/*3)。考察患者在服用氯吡格雷等药物治疗8个月内,CYP2C19基因型以及相关临床危险因素对其药物反应的影响。评价CYP2C19基因型与临床不良终点事件之间的相关性。结果,CYP2C19慢代谢型29例;快代谢型68例;中间代谢型74例。CYP2C19慢代谢基因型合并现时吸烟、糖尿病患者与快、中间代谢基因型相比有统计学意义(P<0.05)。CYP2C19慢代谢基因型患者再发心肌梗死率与快、中代谢基因型相比有统计学意义(P<0.05)。更多还原

【Abstract】 To investigate the impact of CYP2C19 polymorphism and clinical variables on patients with coronary heart disease in clopidogrel treatment.From January 2015 to September 2015,171 patients undergoing percutaneous coronary intervention in our department were enrolled and received 300 mg loading dosage of clopidogrel,75 mg daily maintenance dosage of clopidogrel and aspirin to anti-platelet.Genotyping of CYP2C19 was classified as:extensive(*1/*1)(68cases),intermediate(*1/*2,*1/*3)(74cases)and poor metabolizer(*2/*2,*2/*3,*3/*3)(29cases).The predictive value of the CYP2C19 polymorphism and baseline risk factors for an insufficient anti-platelet response of clopidogrel was analyzed.Poor metabolizer came up with a higher incidence of smoking,diabetes mellitus than the other two genotypes.Clopidogrel treatment was closely associated with poor metabolizer,smoking and diabetes mellitus,which may substantially improve the prediction of clinical outcomes for patients after PCI.更多还原