氯吡格雷治疗急性脑梗死病人CYP2C19基因多态性检测的临床意义

目的:探讨CYP2C19基因多态性检测指导急性脑梗死治疗的意义及其与脑梗死进展之间的关系。方法:急性脑梗死病人206例，入院后完善相关病史资料、体格检查、常规入院检验检查，以及CYP2C19基因检测等项目，按照临床症状进展与否，分为脑梗死进展组和非进展组，据此进一步分析CYP2C19基因检测中的快代谢型、中间代谢型和慢代谢型，其在常规联合抗血小板治疗中对于脑梗死病人临床转归的作用，并进行统计学分析。结果:2组病人CYP2C19基因代谢类型分布差异有统计学意义（P<0.01），进展组病人PM型比例较高，EM型比例较低。结论:CYP2C19基因多态性可能与缺血性脑卒中病人氯吡格雷治疗后病情进展有关。

Clinical significance of the detection of CYP2C19 gene polymorphism in acute cerebral infarction patients treated with clopidogrel

Objective:To investigate the significance of the detection of CYP2C19 gene polymorphism in guiding the treatment of acute cerebral infarction(ACI),and its correlation with the progress of ACI.Methods:The disease history,physical examination,routine admission test and CYP2C19 gene detection in 206 ACI patients were analyzed,and the patients were divided into the progressive cerebral infarction group and non-progressive group according to clinical symptoms.The fast metabolism,intermediate metablism and slow metabolism in the detection of CYP2C19 gene were further analyzed,and the effects of which on the clinical outcome of ACI patients treated with conventional method combined with antiplatelet was statistically analyzed.Results:The difference of the metablism type distribution of CYP2C19 gene between two groups was statistically significant(P<0.01),and the ratios of PM and EM genotypes in progressive cerebral infarction group were higher and lower than those in non-progressive group,respectively.Conclusions:The CYP2C19 gene polymorphism may be related to the disease progress in ischemic stroke patients treated with clopidogrel.