摘要
目的分析氯吡格雷抵抗与冠心病合并高血压患者CYP2C19多态性及不同基因型的关系。方法抽取山西省心血管病医院2018年1月至2019年1月收治的100例冠心病患者为研究对象,根据是否合并高血压分为合并高血压组(n=54)与不合并高血压组(n=46)。纳入患者入院后均给予100 mg阿司匹林及75 mg氯吡格雷治疗。采集患者静脉血标本,采用基因芯片法测定患者CYP2C19基因型,记录、分析患者入院后第1天及服药治疗5 d后的血小板聚集率,观察、记录两组CYP2C19基因的分布情况及氯吡格雷抵抗情况,并进行比较。结果合并高血压组氯吡格雷CYP2C19代谢基因型与不合并高血压组氯吡格雷CYP2C19代谢基因型比较差异未见统计学意义(P>0.05)。两组氯吡格雷抵抗发生情况比较差异也未见统计学差异(P>0.05)。快代谢基因型患者氯吡格雷抵抗发生率(29.41%,10/34)低于慢代谢基因型(72.73%,16/22)及中代谢基因型患者(68.18%,30/44),差异有统计学意义(P<0.05)。Logistic多元回归分析结果提示,CYP2C19基因型为氯吡格雷抵抗发生的独立预测因子(P=0.006)。结论冠心病患者CYP2C19基因多态性、氯吡格雷抵抗与患者是否合并高血压并无关系,但氯吡格雷抵抗与患者的CYP2C19基因多态性存在一定关系。
Objective To study the relationship of clopidogrel resistance(CR)with CYP2C19 polymorphism and different genotypes in patients with coronary heart disease complicated by hypertension.Methods One hundred patients with coronary heart disease admitted to Shanxi Cardiovascular Hospital from January 2018 to January 2019 were enrolled.The patients were divided into hypertension group(n=54)and non-hypertension group(n=46)according to occurrence of hypertension.All patients were given aspirin 100 mg and clopidogrel 75 mg after admission.The venous blood samples were collected from all patients for measuring the CYP2C19 genotype by gene chip method.The platelet aggregation rates of the two groups were recorded and analyzed on the first day after admission and 5 days after administration.And the distribution of CYP2C19 gene and occurrence of clopidogrel resistance in different groups were observed and compared.Results There was no significant difference in the genotypes of CYP2C19 between the hypertension group and non-hypertension group(P>0.05).And there was no statistical difference in incidence of clopidogrel resistance between the two groups(P>0.05).The incidence of clopidogrel resistance in patients with fast metabolizing clopidogrel genotype was 29.41%(10/34),significantly lower than the 72.73%(16/22)in patients with slow metabolizing clopidogrel and 68.18%(30/44)in patients with moderate metabolizing clopidogrel genotype(P<0.05).Logistic multiple regression analysis showed that the genotype of CYP2C19 was an independent predictor of clopidogrel resistance(P=0.006).Conclusions CYP2C19 polymorphism and clopidogrel resistance are not correlated to occurrence of hypertension in patients with coronary heart disease,but clopidogrel resistance has a certain relationship with CYP2C19 polymorphism.
作者
牛怀明
郭李平
邵新
Niu Huaiming;Guo Liping;Shao Xin(Department of Cardiology,Shanxi Cardiovascular Hospital,Taiyuan 030024,China)
出处
《中国实用医刊》
2020年第7期26-29,共4页
Chinese Journal of Practical Medicine
作者简介
通信作者:牛怀明,Email:t7jhbrb5@163.com。
