广东汉族原发性高血压患者CYP2C9和ACE基因多态性的分布特征

目的:观察沙坦类药物代谢酶细胞色素氧化酶P450 2C9(CYP2C9)基因的多态性和血管紧张素Ⅰ转换酶(angiotension I-coverting enzyme,ACE)基因的多态性在广东汉族原发性高血压(essential hypertension,EH)患者中的分布特征。方法:应用PCR、基因测序及琼脂糖凝胶电泳等方法,对206例EH患者CYP2C9和ACE基因型进行检测分析。结果:广东汉族EH患者中CYP2C9基因的1075位C等位基因的频率为3.2%,广东汉族EH患者中CYP2C9*3等位基因的频率与广东人群相比,无显著性差异;ACE基因D、I等位基因的频率分别为56.3%和43.7%。ACE基因的D等位基因频率显著高于广东及国内其他地区正常人群中的频率(P0.05)。结论:在广东汉族EH患者中,未发现CYP2C9*3等位基因与EH有关,而ACE基因的D等位基因可能和EH有关,同时,对EH患者进行CYP2C9和ACE基因的基因型的检测,可能对临床个体化降压治疗具有一定的指导意义。     

CYP2C9 polymorphism in non-steroidal anti-inflammatory drugs-induced gastropathy

OBJECTIVE: Non-steroidal anti-inflammatory drugs (NSAID) induce gastroduodenal mucosal injury and are metabolized by cytochrome P450 2C9 (CYP2C9). It is postulated that CYP2C9 genotype is associated with NSAID-induced gastropathy. This study aims to determine whether individuals with a CYP2C9 allele mutation are susceptible to NSAID-induced gastropathy. METHODS: A total of 109 patients diagnosed as having rheumatic diseases and taking NSAID were appraised as having gastropathy by endoscopy, stool occult blood test and questionnaire two weeks after entering the study. Their peripheral blood was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: A total of 47.7% gastropathy (33% erosions, 14.7% ulcers, 2.75% ulcer bleeding) and 56% dyspeptic symptoms were presented. Only one CYP2C9*2 heterozygote (*1/*2) was found in the group with gastropathy and two variant alleles (CYP2C9*2 and CYP2C9* 3) could not be found in the group without gastropathy. There was no significant difference in both CYP2C9 genotype (0.96%vs 0%) and CYP2C9 variant allele frequency (1.92%vs 0%) between patients with and without gastropathy. CONCLUSION: These results confirm the high prevalence of NSAID-induced gastropathy but do not support the postulation that CYP2C9*2 and CYP2C9*3 contribute to the development of NSAID-induced gastropathy. This may be due to the low frequency of the two alleles in the population studied.     

Rapid detection of the known SNPs of CYP2C9 using oligonucleotide microarray

AIM: Cytochrome P450 2C9 (CYP2C9) is a polymorphic enzyme responsible for the metabolism of a large number of clinically important drugs. Individuals with mutant enzymes may risk serious side effects under routine therapy with certain drugs metabolized by CYP2C9. In order to facilitate the detection of the known SNPs of CYP2C9, an allele-specific oligonucleotide (ASO) based microarray was made. METHODS: An oligonucleotide microarray was made to facilitate the SNP (single nucleotide polymorphism) screening and was applied for the detection of CYP2C9 polymorphism in 62 high blood pressure (HBP) patients who received Irbesartan for treatment. Part of the genotyping results was confirmed by direct sequencing. And the relation between CYP2C9 polymorphism and therapeutic outcome of Irbesartan was statistically analyzed. RESULTS: Heterozygous alleles of CYP2C9*1/*3 were found in 7 out of 62 subjects. No mutant alleles of CYP2C9*2, *4and *5 and no homozygous mutant alleles were detected.The 7 heterozygous CYP2C9*1/*3 and 13 random wild type DNA samples were subjected to direct sequencing with purified PCR products and same genotyping results were obtained with the 20 DNA samples. There was no significant difference in the odds of effectiveness of Irbesartan between the wild type (normal) group and CYP2C9*1/*3 (mutant)group (P＞0.05). CONCLUSION: The oligonucleotide microarray made in this study is a reliable assay for detecting the CYP2C9 known alleles and the heterozygous CYP2C9*1/*3 has no significant effects on the therapeutic outcome of Irbesartan.     

CYP1A1, CYP2E1 and EPHX1 polymorphisms in sporadic colorectal neoplasms

AIM To investigate the contribution of polymorphisms in the CYP1A1, CYP2E1 and EPHX1 genes on sporadic colorectal cancer(SCRC) risk. METHODS Six hundred forty-one individuals(227 patients with SCRC and 400 controls) were enrolled in the study. The variables analyzed were age, gender, tobacco and alcohol consumption, and clinical and histopathological tumor parameters. The CYP1A1 *2A, CYP1A1 *2C CYP2E1 *5B and CYP2E1 *6 polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). The EPHX1 Tyr113 His, EPHX1 His139 Arg and CYP1A1 *2C polymorphisms were detected by real-time PCR. Chisquared test and binary logistic regression were used in the statistical analysis. Haplotype analysis was conducted using the Haploview program, version 2.05.RESULTS Age over 6 2 years was a risk factor for SCRC development(OR = 7.54, 95%CI: 4.94-11.50, P 0.01). Male individuals were less susceptible to SCRC(OR = 0.55, 95%CI: 0.35-0.85, P 0.01). The CYP2E1*5B polymorphism was associated with SCRC in the codominant(heterozygous genotype: OR = 2.66, 95%CI: 1.64-4.32, P 0.01), dominant(OR = 2.82, 95%CI: 1.74-4.55, P 0.01), overdominant(OR = 2.58, 95%CI: 1.59-4.19, P 0.01), and log-additive models(OR = 2.84, 95%CI: 1.78-4.52, P 0.01). The CYP2E1*6 polymorphism was associated with an increased SCRC risk in codominant(heterozygous genotype: OR = 2.81, 95%CI: 1.84-4.28, P 0.01; homozygous polymorphic : OR = 7. 3 2, 9 5 % C I : 1.85-28.96, P 0.01), dominant(OR = 2.97, 95%CI: 1.97-4.50, P 0.01), recessive(OR = 5.26, 95%CI: 1.35-20.50, P = 0.016), overdominant(OR = 2.64, 95%CI: 1.74-4.01, P 0.01), and log-additive models(OR = 2.78, 95%CI: 1.91-4.06, P 0.01). The haplotype formed by the minor alleles of the CYP2E1*5B(C) and CYP2E1*6(A) polymorphisms was associated with SCRC(P = 0.002). However, the CYP1A1 *2A, CYP1A1 *2C, EPHX1 Tyr113 His and EPHX1 His139 Arg polymorphisms were not associated with SCRC.CONCLUSION In conclusion, the results demonstrated that CYP2E1*5B and CYP2E1*6 minor alleles play a role in the development of SCRC.     

Rapid detection of the known SNPs of CYP2C9 using oligonucleotide microarray

AIM: Cytochrome P450 2C9 (CYP2C9) is a polymorphic enzyme responsible for the metabolism of a large number of clinically important drugs. Individuals with mutant enzymes may risk serious side effects under routine therapy with certain drugs metabolized by CYP2C9. In order to facilitate the detection of the known SNPs of CYP2C9, an allele-specific oligonucleotide (ASO) based microarray was made. METHODS: An oligonucleotide microarray was made to facilitate the SNP (single nucleotide polymorphism) screening and was applied for the detection of CYP2C9 polymorphism in 62 high blood pressure (HBP) patients who received Irbesartan for treatment. Part of the genotyping results was confirmed by direct sequencing. And the relation between CYP2C9 polymorphism and therapeutic outcome of Irbesartan was statistically analyzed. RESULTS: Heterozygous alleles of CYP2C9*1/*3 were found in 7 out of 62 subjects. No mutant alleles of CYP2C9*2, *4 and *5 and no homozygous mutant alleles were detected. The 7 heterozygous CYP2C9*1/*3 and 13 random wild type DNA samples were subjected to direct sequencing with purified PCR products and same genotyping results were obtained with the 20 DNA samples. There was no significant difference in the odds of effectiveness of Irbesartan between the wild type (normal) group and CYP2C9*1/*3 (mutant) group (P>0.05). CONCLUSION: The oligonucleotide microarray made in this study is a reliable assay for detecting the CYP2C9 known alleles and the heterozygous CYP2C9*1/*3 has no significant effects on the therapeutic outcome of Irbesartan.     

细胞色素氧化酶P4502C9基因多态性与冠心病及血脂水平的关系

目的 探讨细胞色素氧化酶P450 2C9(CYP2C9)基因多态性与冠心病和血脂水平的相关性.方法 应用聚合酶链反应和基因测序方法,检测218例经冠状动脉造影确诊冠心痛或有明确心肌梗死的患者及200例经冠状动脉造影排除冠心病的对照者的CYP2C9基因型,并对突变基因型者和野生基因型者的血脂按常规方法测定并进行比较分析.结果 冠心病组突变型CYP2C9*3基因发生率显著高于非冠心病对照组(P<0.05),突变型CYP2C9*3基因型者和野生型CYP2C9*1基因型者血脂水平差异无统计学意义.结论 CYP2C9基因多态性与冠心痛的发生可能相关,但未发现与血脂水平有相关性.     

CYP2C9与VKORC1基因变异对华法林初始抗凝治疗反应性的影响

目的 探讨细胞色素P450酶2C9基因(CYP2C9)与维生素K环氧化物还原酶复合物1基因( VKORC1)多态性对中国汉族人华法林初始抗凝治疗反应性的影响.方法 入选2000-2008年广东省人民医院瓣膜置换术后长期口服华法林抗凝治疗的中国汉族患者798例,通过文献检索,选取与华法林药动学和药效学可能相关的CYP2C...     

非瓣膜病房颤与CYP2C9基因多态性的相关性研究

目的：就汉族非瓣膜病房颤与CYP2C9基因多态性进行相关性研究;方法：自2017 年 09月至2019 年 3 月收集来自于山西省不同地区就诊于山西医科大学第二医院心内科的汉族患者,本研究共纳入256例患者,男134例,女122例,将入选对象分为非瓣膜病房颤组143例,对照组113例,所有入选研究对象均无血缘关系;分别对入选对象进行CYP2C9基因型检测,分析基因型与等位基因在两组间有无差异。结果：非瓣膜病房颤组CYP2C9*1/*3 基因型分布频率高于对照组,其中非瓣膜病房颤组为CYP2C9*1/*3 基因型的患者占19例,对照组为CYP2C9*1/*3 基因型的患者仅6例,差异有统计学意义（P=0.035）;非瓣膜病房颤组CYP2C9*3 等位基因分布频率高于对照组,其中非瓣膜病房颤组CYP2C9*3 等位基因19个,对照组CYP2C9*3 等位基因6个,差异有统计学意义（P=0.040）。二元Logistic回归结果示：排除年龄、低密度脂蛋白、高血压等因素的影响后,携带有CYP2C9*1/*3基因型的研究对象患非瓣膜病房颤的风险增加 (OR=2.637, 95%CI=0.989~7.026)。结论：CYP2C9基因多态性是汉族非瓣膜病房颤发生的危险因素。     

Role of polymorphic N-acetyl transferase2 and cytochrome P4502E1 gene in antituberculosis treatment-induced hepatitis

Background and Aim: Antituberculosis drugs, isoniazid and rifampicin, in combination, are known to develop drug‐induced hepatotoxicity (DIH). A higher risk of DIH during antituberculosis treatment (ATT) has been reported in the Indian subcontinent compared to its Western counterparts. The role of genetic factors in a higher incidence of ATT hepatotoxicity in the Indian population is still unclear. The present study was aimed at investigating the role of the N‐acetyltransferase2 (NAT2) and cytochrome P4502E1 (CYP2E1) gene polymorphisms in ATT hepatotoxicity. Methods: The study population included 218 pulmonary tuberculosis patients who were started on ATT and followed up for the occurrence of ATT‐induced hepatitis. The genetic polymorphisms of the NAT2 and CYP2E1 genes were studied by polymerase chain reaction–restriction fragment length polymorphism. Results: The occurrence of DIH was 18.8% (41/218). There was a higher prevalence of NAT2 slow‐acetylator genotypes in DIH (70.73%) compared to non‐DIH (44.63%; P < 0.05). The frequency of the NAT2*5/*7 and NAT2*6/*7 genotypes was significantly higher in DIH than non‐DIH (19.51% vs 6.78%, and 19.51% vs 5.08%). No association of the CYP2E1 RsaI polymorphism could be demonstrated with DIH. However, the DraI C/D genotype of the CYP2E1 gene was mostly prevalent in DIH (85.37%), compared to non‐DIH (64.41%) (P < 0.05). Slow‐acetylator status and the CYP2E1 C/D or C/C genotype together showed a higher frequency in DIH (65.85%) compared to non‐DIH (28.81%) (P < 0.0001). Conclusion: The study demonstrates for the first time a possible association between the DraI polymorphism of the CYP2E1 gene and the risk of ATT hepatotoxicity. The genotyping of the NAT2 and CYP2E1 genes could possibly identify the groups at highest risk of developing ATT‐induced hepatitis prior to medication.     

Establishment of a transgenic cell line stably expressing human cytochrome P450 2C18 and identification of a CYP2C18 clone with exon 5 missing

AIM：The human cytochrome P4502C18(CYP2C18)has been characterized.However,the protein has not been purified fromliver and very little is known regarding the specific substrate of CYP2C18.In or der to study its enzymatic activity for drug metabolism,the CYP2C18cDNA was cloned and a stable CHL cell line expressing recombinant CYP 2C18was established.METHODS;The human CYP2C18cDNA was amplified with reverse transcrition-polymerase chain reaction(RT-PCR)from total RNAs extracted from human liver and cloned into pGEM-Tvector.The cDNA segment was identified by DNA sequencing and subcloned into a mammalian expression vector pREP9.A transgenic cell line was established by transfecting the recombinant plasmid of pREP9-CYP2C18to Chinese hamster lung(CHL)cell.The enzyme activity of CYP2C18 catalyzing oxidation of tolbutamide to hydroxytolbutamide in postmitochondrial supernant(S9)fraction of the cell was determined by high performance liquid chromatography(HPLC).RESULTS:The amino acid sequence predicted from the cloned cDNA segment was identical to that of reported by Romkes et al(GenBank accession number;M61856.J05326).The S9 fraction of the established cell line metabolizes tolbutamide to hydroxytolbutamide.Tolbutaminde hydroxylase activity was found to be 0.509&#177;0.052μmol&#183;min^-1A&#183;g^-1S9proteinof 8.82&#177;0.90mol&#183;min ^-1&#183;mol^-1CYP,but was undetectable in parental CHL cell,In addition,we have identified a CYP2C18cDNA clone with exon 5missing.CONCLUSION;The cDNA of human CYP2C18 was successfully cloned and a cell ine,CHL-CYP2C18,efficiently expressing the protein of CYP2C18,was established.A spliced variant of CYP2C18with exon 5missing was identified in the cloning process.     

Cytochrome P4502C9(CYP2C9) gene polymorphism and safety of therapy with warfarin

Aim of the study was to investigate frequency and influence of alleles CYP2C9*2 and CYP2C9*3 on pharmacokinetics, pharmacodynamics and dosing regimen of warfarin and on development of hemorrhagic complications. We included 84 patients (mean age 62,8 +/- 10,5 years). Duration of follow-up varied between 1 month and 1 year. Carriage of allele variants was determined by polymerase chain reaction, measurement of plasma wafarin concentration was carried out with the help of high performance liquid chromatography. Wild type (CYP2C9*1/*1) was found in 68% of patients; overall frequency of 2C9*1/*1, *l/*3, *2/*2, *3/*3, *2/*3 genotypes was 32%. Average maintenance doses of warfarin for patients with allele variants CYP 2C9 *2 and 2C9 *3 were 3.6 and 3.1 mg/day, respectively, what was significantly lower than in wild type homozygotes (6.1 mg/day). Wild type homozygotes (1) had the highest warfarin clearance (3,51 ml/min). In carriers of 2C9 *2(2) and 2C9 *3(3) warfarin clearance was significantly lower (2.42 and 1.82 ml/min; p1 - 2 = 0,05; p1 - 3 = 0,0008). In carriers of allele variants CYP2C9*2, CYP2C9*3 values of international normalized ratio > 3,0 were met more often, especially in carriers of CYP2C9*3 (in 100% of cases) vs. 28% in wild type homozygotes (p=0,02). Carriers of CYP2C9*3 compared with wild type homozygotes had more hemorrhagic complications (67% and 16%, respectively, p=0,0008). Thus cytochrome P450 2C9 gene polymorphism influences frequency of development of hemorrhagic complications, metabolic clearance, and magnitude of warfarin maintenance dose.     

Study of the association between cytochromes P450 2D6 and 2E1 genotypes and the risk of drug and chemical induced idiosyncratic aplastic anaemia

A genetic susceptibility to drug or chemical toxicity may provide a basis for an increased risk of idiosyncratic aplastic anaemia (AA). The cytochrome P450 enzymes are responsible for the metabolism of many drugs, some of which have been linked to AA. Mutations in the cytochrome P450 CYP2D6 gene result in absent or impaired enzyme activity in about 7% of Caucasians, whereas a specific mutation in the 5'-regulatory region of the CYP2E1 gene causes overexpression of the gene. We evaluated the frequency of allelic variants of CYP2D6 and CYP2E1 using allele-specific PCR amplification and restriction enzyme analysis of blood mononuclear cell DNA among 54 Caucasian AA patients. CYP2D6 and CYP2E1 were chosen because of the link between AA and the antipsychotic drug remoxipride (CYP2D6 substrate) and benzene (CYP2E1 substrate), respectively. Results were compared with 53 controls matched for age, sex and ethnicity. The percentage of AA patients homozygous for the CYP2D6*3, CYP2D6*4 alleles (poor metabolizer phenotype) and the CYP2E1 mutant allele (overexpression) was 0%, 4% and 0%, respectively, and the percentage of heterozygotes was 2%, 28% and 15%, respectively. For normal controls the corresponding results for homozygous mutants were 0%, 4% and 0% and for heterozygotes 4%, 25% and 6%, respectively. We concluded that there were no major differences in the frequencies of the genetic polymorphisms between this series of AA patients and controls, but due to the low number of cases with the poor metabolizer phenotype and those with a history of drug exposure, the power of the study was too low to disprove an interaction.     

Cytotoxicity and Apoptosis Produced by Arachidonic Acid in HepG2 Cells Overexpressing Human Cytochrome P-4502E1

The goal of the current study was to evaluate the effects of arachidonic acid, as a representative polyunsaturated fatty acid, on the viability of a HepG2 cell line, which has been transduced to express human cytochrome P4502E1 (CYP2El). Arachidonic acid produced a concentration- and time-dependent toxicity to HepG2-MV2E1-9 cells, which express CYP2E1, but little or no toxicity was found with control cells. In contrast to arachidonic acid, oleic acid was not toxic to the HepG2-MV2E1-9 cells. The cytotoxicity of arachidonic acid involved a lipid peroxidation type of mechanism since toxicity was enhanced after depletion of cellular glutathione; formation of malon-dialdehyde and 4-hydroxy-2-nonenal was markedly elevated in the cells expressing CYP2E1, and toxicity was prevented by antioxidants and the iron chelator desferrioxamine. The CYP2E1-dependent arachidonic acid toxicity appeared to involve apoptosis, as demonstrated by terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling and DNA laddering experiments. Trolox, which prevented toxicity of arachidonic acid, also prevented the apoptosis. Transfection with a plasmid containing bcl-2 resulted in complete protection against the CYP2E1-dependent arachidonic acid toxicity. It is proposed that elevated production of reactive oxygen intermediates by cells expressing CYP2E1 can cause lipid peroxidation, which subsequently promotes apoptosis and cell toxicity when the cells are enriched with polyunsaturated fatty acids such as arachidonic acid.     

细胞色素氧化酶P4502 C9以及维生素K环氧化物还原酶复合体1基因多态性对华法林抗凝疗效的影响

目的 研究年龄、体重、身高、体表面积、细胞色素氧化酶P450(CYP2C9)和维生素K环氧化物还原酶复合体1(VKORC1)基因型与华法林剂量的关系.方法 收集临床使用华法林的患者共191例,记录患者的年龄、性别、身高、体重等.利用聚合酶链反应(PCR)和限制性内切酶片段长度多态性(RFLP)技术检测CYP2C9以及VKORC1基因型.结果 VKORC1(-1639G＞A)基因型检测有159例患者为突变纯合子AA型,31例患者为杂合子GA型,1例患者为纯合子GG型.CYP2C9基因型检测有176例患者为*1/*1型,15例患者为杂合子*1/*3型.VKORC1(-1639G＞A)GA+GG组,华法林平均剂量明显高于AA组[(3.36±0.97)mg/d比(1.75±0.56)mg/d,P＜0.01].CYP2C9*1/*1型患者华法林平均剂量高于杂合子*1/*3型患者[(2.06±0.83)mg/d比(1.55±1.32)mg/d,P＜0.05].多元线形回归分析提示年龄、体重以及VKORC1基因型分别解释了约9.3％、7.4％、51.9％的个体间剂量差异,包括年龄、体重、VKORC1和CYP2C9基因型的多变量模型能解释个体间剂量差异约为64.1％.结论 年龄、体重、VKORC1和CYP2C9基因多态性明显影响了华法林剂量.用年龄、体重、VKORC1和CYP2C9基因型的多变量模型给药方法希望提高华法林使用的安全性.     

Removal of glutathione produces apoptosis and necrosis in HepG2 cells overexpressing CYP2E1

BACKGROUND: Previous studies have shown that addition of ethanol, iron, or arachidonic acid to HepG2 cells expressing CYP2E1 produced a loss in cell viability and caused apoptosis. These effects were enhanced when cellular reduced glutathione (GSH) levels were lowered by treatment with buthionine sulfoximine (BSO). Overexpression of CYP2E1 in HepG2 cells could produce toxicity even in the absence of added toxin after BSO treatment. Studies were carried out to characterize this CYP2E1-and BSO-dependent toxicity. METHODS: HepG2 cells expressing CYP2E1 were treated with BSO for 1 to 4 days, and various parameters associated with apoptosis and cell viability were assayed. RESULTS: Treatment of cells expressing CYP2E1 (E47 cells) with BSO resulted in apoptosis as well as necrosis. The apoptosis and necrosis were independent of each other. No toxicity was found with control HepG2 cells or HepG2 cells expressing CYP3A4 instead of CYP2E1 under these conditions. The antioxidant trolox partially prevented the apoptosis and necrosis, whereas diallylsulfide, a CYP2E1 inhibitor, was fully protective. The activity of caspase 3, but not caspases 1, 8, or 9, was increased in the BSO-treated E47 cells, and an inhibitor of caspase 3 prevented apoptosis. Damage to mitochondria appears to play a role in the CYP2E1- and BSO-dependent toxicity, because mitochondrial membrane potential was decreased and cyclosporin A, an inhibitor of the mitochondrial membrane permeability transition, prevented the apoptosis and the necrosis. The fall in membrane potential was prevented by trolox and diallylsulfide, suggesting damage to the mitochondria by CYP2E1-derived reactive oxygen species. CONCLUSIONS: These results indicate the critical role of GSH in protecting against CYP2E1-mediated oxidative stress and that mitochondria may be a target for CYP2E1-derived reactive oxygen species, and suggest that interactions between CYP2E1, mitochondria, and altered GSH homeostasis may play a role in alcohol-induced liver injury.     

侵袭性真菌感染患者细胞色素P_(450)2C19遗传多态性分析

目的 探讨细胞色素P_(450)2C19(CYP2C19)遗传多态性在侵袭性真菌感染患者中的分布情况.方法 采用PCR-限制性片段长度多态性(PCR-RFLP)技术检测134例侵袭性真菌感染患者和134例健康对照者CYP2C19基因2个主要单核苷酸多态性位点CYP2C19*2和CYP2C19*3的基因型,比较两组各等位基因频率及代谢型的比例.结果 侵袭性真菌感染病例组CYP2C19*1等位基因频率为58.2%,CYP2C19*2等位基因频率为36.6%,CYP2C19*3 等位基因频率为5.2%.对照组CYP2C19*1等位基因频率为63.4%,CYP2C19*2 等位基因频率为34.3%,CYP2C19*3 等位基因频率为2.2%,两组间差异无统计学意义.侵袭性真菌感染组纯合快代谢、杂合快代谢以及慢代谢型比例分别为33.6%、50.0%、16.4%,对照组比例为40.3%、48.5%、11.2%,两组差异无统计学意义.结论 在本组侵袭性真菌感染患者以及健康人群中存在明显CYP2C19遗传多态性,且近2/3患者为杂合快代谢型或慢代谢型.因此,在治疗过程中应重视CYP2C19遗传多态性对药物代谢的影响.