CYP2C19、CYP3A4基因多态性与十二指肠球部溃疡疗效的关系

目的检测肝脏细胞色素氧化酶CYP2C19、CYP3A4的基因多态性，并观察不同基因多态性患者予奥美拉唑治疗十二指肠溃疡的疗效，以明确CYP2C19、CYP3A4基因多态性对药物治疗效果的影响。方法65例十二指肠溃疡患者分别检测CYP2C19、CYP3A4基因多态性及幽门螺杆菌（Hp），予奥美拉唑治疗及根治Hp治疗，观察治疗后腹痛缓解情况，并复查胃镜，观察溃疡缩小情况。结果在65例患者中，CYP2C19t3基因野生型为43例（66．15％），突变型为12例（18．46％），杂合型为10例（15．38％），CYP3A4＊18未见基因多态性。CYP2C19＊3突变型腹痛缓解时间短于野生型及杂合型（P〈0．01）。治疗后2周CYP2C19＊3突变型患者溃疡缩小率大于野生型及杂合型（P〈0.01），但治疗后4周无明显差异（P〉0．05）。结论在观察病例中可见CYP2C19基因多态性，未见CYP3A4基因多态性，CYP2C19基因多态性影响奥美拉唑治疗十二指肠溃疡的疗效。

CYP2C19 and CYP3A4 gene polymorphism with the therapeutic effect of omeprazole in patients with duodenal ulcer

Objective To investigate the association of CYP2C19 and CYP3A4 gene polymorphism with the therapeutic effect of omeprazole in patients with duodenal ulcer. Methods CYP2C19 and CYP3A4 gene polymorphism and Helicobacter Pylori （HP） were tested in 65 patients with duodenal ulcer. Omeprazole and HP radical therapy was applied and abdominal pain relief degree was observed. The changes of ulcer size were observed by gastroscopy. Results CYP2C19 ＊ 3 wild type was detected in 43 cases （66.15%）, mutation type in 12 （18.46%） and hybrid type in 10 （15.38%）. No gene polymorphism was detected in CYP3A4 ＊ 18. The time for pain relief was shorter in patients with CYP2C19 ＊ 3 mutation type than that in wild type and hybrid type （P〈0.01）. After 2-week treatment ulcer reduction rate was higher in the CYP2C19 ＊ 3 mutation type, while it there was no difference among all groups after 4-week treatment. Conclusion CYP2C19 gene polymorphism may influence the therapeutic effect of omeprazole in treatment of duodenal ulcer.