CYP2C19基因多态性与不同类型急性冠脉综合征的关系

目的探讨肝细胞色素P450氧化酶（CYP450）中CYP2C19基因多态性与两种不同类型急性冠脉综合征（ACS）的关系。方法选择确诊的ACS病人203例，入院当天完善同步12导联心电图监测，入院第2天检测病人心肌酶学指标。应用PCR及基因测序技术检测所有病人的CYP2C19基因型。所有病人经冠状动脉造影明确冠脉受累情况。结果ST段抬高型ACS组与非ST段抬高型ACS组病人CYP2C19基因多态性差异无统计学意义（P>0.05），2组病人血糖、C反应蛋白（CRP）、高密度脂蛋白胆固醇（HDL-C）、血清同型半胱氨酸（HCY）水平、高血压患病率差异有统计学意义（P < 0.05~P < 0.01）。Logistic回归分析提示，2组ACS病人CYP2C19基因多态性差异无统计学意义（OR=0.71，P>0.05），但血糖、CRP、HCY、HDL-C水平以及高血压患病率差异有统计学意义（P < 0.05）。结论CYP2C19多态性与不同ACS类型无明显关联，但ST段抬高型ACS病人可能有更高的血糖、HCY、CRP和更低的HDL-C水平。

The relationship between CYP2C19 gene polymorphisms and different types of acute coronary syndromes

ObjectiveTo investigate the relationship of CYP2C19 gene polymorphisms in cytochrome P450 oxidase(CYP450) and two types of acute coronary syndromes(ACS).MethodsThe 12-lead ECG monitoring in 203 cases with ACS on admisssion were examined, and the myocardial enzyme indictors in all cases were examined on the second day after admission.The CYP2C19 genotypes of all patients were detected by PCR and gene sequencing technique.The coronary involvement in all patients were identified using coronary angiography(CAG).ResultsThe difference of the CYP2C19 gene polymorphisms between ST-segment elevation ACS group and non-ST-segment elevation ACS group was not statistically significant(P>0.05), and the differences of the levels of blood glucose, C-reactive protein(CRP) and serum homocysteine, and prevalence rate of hypertension between two groups were statistically significant(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that there was no statistical significance in CYP2C19 gene polymorphisms between two groups(OR=0.71, P>0.05), and the differences of the levels of blood glucose, CRP, HCY and HDL-C and prevalence rate of hypertension between two groups were statistically significant(P < 0.05).ConclusionsThere is no association between CYP2C19 polymorphism and different types of ACS, and the levels of blood glucose, HCY and CRP, and HDL-C level in patients with ST-segment elevation ACS may be higher and lower, respectively.