[1]曹美娜,刘小平,郑艳安,等.CYP2C19基因型对急性心脑血管梗塞患者预后的影响[J].医学信息,2024,37(03):109-113.[doi:10.3969/j.issn.1006-1959.2024.03.021]
　CAO Mei-na,LIU Xiao-ping,ZHENG Yan-an,et al.Effect of CYP2C19 Genotype on the Prognosis of Patients with Acute Cardiovascular and Cerebrovascular Infarction[J].Journal of Medical Information,2024,37(03):109-113.[doi:10.3969/j.issn.1006-1959.2024.03.021]
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CYP2C19基因型对急性心脑血管梗塞患者预后的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年03期
页码:
109-113
栏目:
论著
出版日期:
2024-02-01

文章信息/Info

Title:
Effect of CYP2C19 Genotype on the Prognosis of Patients with Acute Cardiovascular and Cerebrovascular Infarction
文章编号:
1006-1959（2024）03-0109-05
作者:
曹美娜; 刘小平; 郑艳安; 等
（鄂尔多斯市中心医院分子医学实验室1，心血管内科2，神经内科3，感染管理科4，内蒙古 鄂尔多斯 017010）
Author(s):
CAO Mei-na; LIU Xiao-ping; ZHENG Yan-an; et al.
(Laboratory of Molecular Medicine1,Department of Cardiovascular Medicine2,Department of Neurology3,Department of Infection Control4,Ordos Central Hospital,Ordos 017010,Inner Mongolia,China)
关键词:
CYP2C19基因; 氯吡格雷; 急性心脑血管梗塞
Keywords:
CYP2C19 gene; Clopidogrel; Acute cardiovascular and cerebrovascular infarction
分类号:
R969
DOI:
10.3969/j.issn.1006-1959.2024.03.021
文献标志码:
A
摘要:
目的 探讨急性心脑血管梗塞患者中CYP2C19基因多态性的分布特征及其检测在临床治疗中的指导价值。方法 选取2017年12月-2022年12月鄂尔多斯市中心医院收治的225例急性心脑血管梗塞患者作为研究对象，检测CYP2C19基因型，将患者按照对氯吡格雷代谢反应快慢不同分为A组（快代谢型）、B组（中间代谢型）、C组（慢代谢型）。所有患者均接受基础对症治疗、支持治疗及阿司匹林治疗，给予常规剂量硫酸氢硫酸氢氯吡格雷（75 mg/d），比较三组生理生化指标、CYP2C19基因型及术后3个月内不良事件发生情况。结果 三组各项生理生化指标比较，差异无统计学意义（P＞0.05）；225例患者携带CYP2C19*2和*3突变杂合子的分别为84例和20例，携带CYP2C19*2和*3突变纯合子的分别为13例和0例。A组*1/*1者104例，*1/*17者4例，B组*1/*2者79例，*1/*3者20例，*2/*17者5例，C组*2/*2者13例。B组心源性再住院发生率高于A组和C组，差异有统计学意义（P＜0.05）；三组其余不良事件发生率比较，差异无统计学意义（P＞0.05）。结论 急性心脑血管梗塞患者术后应用硫酸氢氯吡格雷抗凝预后一定程度上受CYP2C19基因多态性的影响，CYP2C19基因检测对临床术后抗血小板治疗具有重要的指导价值，需要进一步的研究。
Abstract:
Objective To investigate the distribution characteristics of CYP2C19 gene polymorphism in patients with acute cardiovascular and cerebrovascular infarction and its guiding value in clinical treatment.Methods A total of 225 patients with acute cardiovascular and cerebrovascular infarction admitted to Ordos Central Hospital from December 2017 to December 2022 were selected as the research objects. The CYP2C19 genotype was detected. The patients were divided into group A (fast metabolic type), group B (intermediate metabolic type) and group C (slow metabolic type) according to the speed of clopidogrel metabolic reaction. All patients received basic symptomatic treatment, supportive treatment and aspirin treatment, and received conventional dose of clopidogrel hydrogen sulfate (75 mg/d). The physiological and biochemical indexes, CYP2 C19 genotype and adverse events within 3 months after operation were compared among the three groups.Results There was no significant difference in physiological and biochemical indexes among the three groups (P>0.05). Among 225 patients, 84 patients and 20 patients carried CYP2C19*2 and *3 mutation heterozygotes respectively, and 13 patients and 0 patient carried CYP2C19*2 and *3 mutation homozygotes respectively. In group A, there were 104 patients of *1/*1 and 4 patients of *1/*17; in group B, there were 79 patients of *1/*2, 20 patients of *1/*3 and 5 patients of *2/*17; in group C, there is 13 patients of *2/*2. The incidence of cardiogenic rehospitalization in group B was higher than that in group A and group C, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of other adverse events among the three groups (P>0.05).Conclusion The prognosis of clopidogrel bisulfate anticoagulation in patients with acute cardiovascular and cerebrovascular infarction is affected by CYP2C19 gene polymorphism to a certain extent. CYP2C19 gene detection has important guiding value for clinical postoperative antiplatelet therapy, which needs further research.

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更新日期/Last Update: 1900-01-01