【摘要】 目的:探讨氯吡格雷药物代谢相关基因CYP2C19多态性对冠心病(CHD)经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)后患者预后的影响。方法:选取我院2015年1月至2016年7月经冠状动脉造影诊断为冠心病且成功行PCI术,并坚持服用硫酸氯吡格雷的患者356例,记录患者术后12个月内可能的支架内再狭窄发生情况。所有患者于PCI术前采用聚合酶链反应和基因测序法检测CYP2C19多态性,根据基因结果将其分为快代谢型、携带CYP2C19*2或CYP2C19*3中慢代谢基因型,对两组患者基本临床资料、实验室指标、CYP2C19基因分布进行分析。结果:两组患者在性别、年龄、体重指数(body mass index,BMI)、低密度脂蛋白(low density lipoprotein,LDL)、糖化血红蛋白(HBA1C)、收缩压、肌酐清除率、吸烟史、心脏射血分数(EF值)等基本临床资料比较差异无统计学意义(P>0.05)。发现中慢代谢型比快代谢型患者支架内再狭窄事件有更高的发生率,差异有统计学意义(P<0.05)。结论:携带CYP2C19*2或CYP2C19*3中慢代谢基因型的冠心病PCI术后患者比快代谢型患者支架再闭塞发生率增加。更多还原

【Abstract】 Objective: To explore the impact of polymorphisms distribution of clopidogrel metabolism related gene CYP2C19 on stent restenosis after percutaneous coronary intervention( PCI) of CHD patients. Methods: 356 patients diagnosed CHD by coronary angiogarphy and successfully underwent PCI treatment from January 2015 to August 2016 in our hospital were enrolled in the study. The postoperative incidence of stent restenosis within 12 months was recorded. Ploymerase chain reaction( PCR) and DNA sequencing methods were used to detect the genotypes of CYP2C19 polymorphisms. We divided the patients into two groups by the result of the genotypes of CYP2C19 polymorphisms,one group was normal metabolize genotypes of CYP2C19 polymorphisms,another group was intermediate and slower metabolize genotypes of CYP2C19 polymorphisms,which had CYP2C19*2 or CYP2C19*3. Results: The basic clinical data( including gender,age,BMI,LDL,HBA1 C,systolic pressure,creatinine clearance rate,history of smoking and EF) had no statistical significance between two groups( P > 0. 05). We found there was a lower incidence of stent restenosis in patients with normal metabolize types of CYP2C19 polymorphisms than in patients with intermediate metabolize type and poor metabolize types CYP2C19( P < 0. 05). Conclusion: Patients with coronary artery disease who have CYP2C19*2 or CYP2C19*3 intermediate and slower metabolic genotype have increased incidence of stent restenosis after PCI.更多还原