摘要
目的探讨CYP2C19基因多态性与高龄缺血性脑卒中患者氯吡格雷抵抗的关系。方法选取2015年6月—2016年6月上海中医药大学附属普陀医院神经内科和急诊内科收治的高龄缺血性脑卒中患者85例,根据CYP2C19基因型分为A组(快代谢型,n=31)、B组(中间代谢型,n=42)、C组(慢代谢型,n=12)。所有患者口服氯吡格雷和阿司匹林。比较3组患者一般资料、血小板聚集抑制率、氯吡格雷抵抗发生率。结果 3组患者性别、年龄、吸烟率、饮酒率、高血压发生率、糖尿病发生率、高脂血症发生率、他汀类药物使用率、β-受体阻滞剂使用率、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)使用率比较,差异无统计学意义(P>0.05)。B、C组患者血小板聚集抑制率低于A组,C组患者血小板聚集抑制率低于B组(P<0.05)。A组患者氯吡格雷抵抗发生率低于C组(P<0.05),而A组与B组、B组与C组患者氯吡格雷抵抗发生率比较,差异无统计学意义(P>0.05)。结论 CYP2C19基因多态性与高龄缺血性脑卒中患者氯吡格雷抵抗有关,携带慢代谢型CYP2C19基因型的高龄缺血性脑卒中患者氯吡格雷抵抗发生风险较高。
Objective To investigate the relationship between CYP2C19 gene polymorphism and clopidogrel resistance in elderly patients with ischemic stroke. Methods From June 2015 to June 2016 in the Department of Neurology and Department of Emergency Medicine, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, a total 85 elderly- patients with ischemic stroke were selected, and they were divided into A group （with extensive metabolism, n = 31） , B group （with intermediate metabolism, n = 42 ） and C group （ with poor metabolism, n = 12 ） according to CYP2C19 genotypes. Patients of the three groups received oral clopidogrel combined with aspirin. General information, inhibition rate of platelet aggregation and incidence of clopidogrel resistance were compared among the three groups. Results No statistically significant differences of gender, age, smoking rate, drinking rate, incidence of hypertension, diabetes or hyperlipidaemia, using rate of statins, （3 - receptor blockers or ACEI/ARB was found among the three groups （ P 〉 0. 05 ） . Inhibition rate of platelet aggregation of B group and C group was statistically significantly lower than that of A group, respectively, meanwhile inhibition rate of platelet aggregation of C group was statistically significantly lower than that of B group （ P 〈 0. 05 ） . Incidence of clopidogrel resistance of A group was statistically significantly lower than that of C group （ P 〈 0. 05 ） , while no statistically significant differences of incidence of clopidogrel resistance was found between A group and B group, nor was between B group and C group （ P 〉 0. 05 ） . Conclusion CYP2C19 gene polymorphism is significantly associated with clopidogrel resistance in elderly patients with ischemic stroke, risk of clopidogrel resistance significantly increases in elderly ischemic stroke patients with poor metabolism of CYP2C19 genetype.
出处
《实用心脑肺血管病杂志》
2017年第6期28-31,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
作者简介
通信作者：李英梅,E-mail：liyingmei@yeah.net
