【摘要】 目的通过对冠心病和脑卒中患者的CYP2C19基因多态性进行分析,为临床血小板聚集抑制剂的个体化应用,推进精准药物治疗提供依据。方法采用实时荧光定量RT-PCR对4 270例冠心病患者和141例脑卒中患者的基因型和代谢型进行分析。统计每种基因型和代谢型的分布情况,并探讨不同性别、不同年龄以及不同病种之间的基因型和代谢型是否具有统计学差异。结果冠心病患者中,男性、女性人群基因型分布前3位分别为*1/*1、*1/*2、*2/*2型,以及*1/*2、*1/*1、*2/*2型,中青年与老年人群的基因型分布前3位均分别为*1/*1、*1/*2、*2/*2型;不同性别、不同年龄人群代谢型均为中代谢型最多。脑卒中患者中,男性、女性人群基因型分布前3位分别为*1/*1、*1/*2、*1/*3型,以及*1/*1、*1/*2、*2/*2型,中青年与老年人群的基因型分布前3位均分别为*1/*1、*1/*2、*2/*2;不同性别、不同年龄人群代谢型均为快代谢型最多。不同病种之间的基因型分布前3位均分别为*1/*1、*1/*2、*2/*2型,冠心病人群代谢型为中代谢型最多,脑卒中人群代谢型为快代谢型最多。以上年龄组、性别组之间均无统计学差异(P>0.05)。结论冠心病和脑卒中患者存在基因多态性,建议临床使用氯吡格雷等血小板聚集抑制剂之前进行CYP2C19基因型检测,避免出现氯吡格雷抵抗。更多还原

【Abstract】 Objective To analyze the polymorphism of CYP2 C19 gene in patients with coronary heart disease or stroke and provide a basis for the personalized application of clinical anticoagulant drugs.Methods Real-time fluorescence quantitative RT-PCR was used to analyze the genotypes and metabolites of 4 270 patients with coronary heart disease and 141 patients with stroke.Results The distribution of each genotype and metabolic type was caculated, and the genotype and metabolic type was compared statistically between different genders, different ages, and disease types.Among the patients with coronary heart disease, the top three genotype distributions of male and female populations were *1/*1,*1/*2,*2/*2,and *1/*2,*1/*1,*2/*2,the top three genotypes of the middle-aged and elderly population were *1/*1,*1/*2,*2/*2;the metabolic types of people of different genders and ages were the most metabolic type.Among stroke patients, the top three genotype distributions of male and female populations were *1/*1,*1/*2,*1/*3,and *1/*1,*1/*2,*2/*2,the top three genotype distributions of middle-aged and elderly populations were *1/*1,*1/*2,*2/*2;the metabolic types of people of different genders and ages were fast The most metabolic type.The top three genotype distributions among different disease types were *1/*1,*1/*2,and *2/*2.The metabolic type of coronary heart patients was middle metabolic type, and the metabolic type of stroke population.It was the most metabolic type.There was no statistical difference between the above groups(P>0.05).Conclusions There are genetic polymorphisms in patients with coronary heart disease and stroke.It is recommended that CYP2 C19 genotype should be tested before anticoagulant drugs is used clinically to avoid clopidogrel resistance.更多还原