【摘要】 目的研究CYP2C19基因多态性对冠心病患者经皮冠状动脉介入治疗(PCI)后抗凝治疗预后的关系。方法选择2017年6月-2018年12月在我院诊治的冠心病经PCI治疗,并检测CYP2C19基因的96例患者。根据检测CYP2C19基因分类分为三组,快代谢型为A组(n=40),中间代谢为B组(n=30),慢代谢为C组(n=26)。随访三组8个月内突发心肌梗死、脑血管意外、出血、死亡、凝血指标、血液指标。结果三组患者一般资料差异均无统计学意义(P>0.05);采用单因素方差分析,三组TC、TG、HDL、LDL、PLT无统计学差异(P>0.05);治疗后,A组PT、APTT、TT、Fib指标高于B、C组(P<0.05);采用单因素方差分析,非计划二次血运重建发生率差异有统计学意义(P<0.05),出血、心肌梗死、脑血管意外、死亡差异均无统计学意义(P>0.05)。结论冠心病PCI术后患者依据CYP2C19基因多态性开展具有针对性指导性抗凝治疗,减少不良事件发生,改善预后。更多还原

【Abstract】 Objective To investigate relationship between CYP2 C19 gene polymorphism and prognosis of anticoagulant therapy in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods 96 patients with coronary heart disease underwent anticoagulant therapy with clopidogrel after PCI in our hospital from March 2017 to March 1818 were selected.According to the CYP2 C19 genotype,patients were divided into fast metabolic group(group A,n=40),intermediate metabolic group(group B,n=30),and slow metabolic group(group C,n=26).Sudden myocardial infarction,cerebrovascular accident,hemorrhage,death,coagulation indexes and blood index were compared among groups during the post-treatment 8-mon follow-up.Results General data among the three groups showed no difference among groups(P>0.05).Univariate analysis of variance showed no significant difference in TC,TG,HDL,LDL and PLT among the three groups(P>0.05).After treatment,the PT,APTT,TT and Fib of group A was higher than that of group B and C(P<0.05).Univariate analysis of variance showed that there was significant difference in the incidence of unplanned secondary revascularization(P<0.05),and no significant difference was found in hemorrhage,myocardial infarction,cerebrovascular accident and death(P>0.05).Conclusion Targeted and directive anticoagulation therapy based on CYP2 C19 gene polymorphism among patients with coronary artery disease after PCI is of vital importance for the decrease of adverse reactions and improvement of the prognosis.更多还原