CYP2C19基因多态性与氯吡格雷抗血小板作用的关系研究

目的探讨CYP2C19基因多态性与氯吡格雷抗血小板作用的关系。方法收集2017年12月25日～2018年10月9日我院治疗的250例冠心病患者,通过基因芯片检测试剂盒鉴定CYP2C19基因型,根据CYP2C19基因多态性检测结果将患者分为野生型组和突变型组。通过光比浊法测定两组患者的血小板抑制率,并比较两组患者的氯吡格雷抵抗情况。结果 250例患者中,CYP2C19野生型145例(58.00%),突变型105例(42.00%)。野生型组的血小板抑制率(75.96±11.50)%显著高于突变型组(47.13±7.97)%(P0.05)。250例患者中共有59例(23.6%)发生氯吡格雷抵抗现象,其中野生型组13例(8.97%),突变型组46例(43.81%),差异具有统计学意义(P0.05)。结论 CYP2C19基因多态性、糖尿病、体质指数是氯吡格雷抵抗的重要影响因素,检测CYP2C19基因多态性、是否患有糖尿病、体质指数有助于指导患者的抗血小板治疗。

Relationship between CYP2C19 gene polymorphism and anti-platelet effect of clopidogrel

Objective To investigate the relationship between CYP2C19 gene polymorphism and anti-platelet effect of clopidogrel.Methods A total of 250 patients with coronary heart disease who were treated in our hospital from December 25,2017 to October 9,2018 were enrolled.The CYP2C19 genotype was identified by the gene chip detection kit.And the patients were divided into wild type group and mutant group according to the CYP2C19 gene polymorphism test results.The platelet inhibition rate of the two groups was determined by turbidimetry,and the clopidogrel resistance of the two groups was compared.Results Of the 250 patients,145 cases(58.00%)had CYP2C19 wild type and 105 cases(42.00%)had mutant type.The platelet inhibition rate of the wild type group(75.96±11.50)%was significantly higher than that of the mutant group(47.13±7.97)%(P<0.05).A total of 59 cases(23.6%)of the 250 patients developed clopidogrel resistance,including 13 cases in the wildtype group(8.97%)and 46 cases in the mutant group(43.81%).The difference was statistically significant(P<0.05).ConclusionCYP2C19 gene polymorphism,diabetes and body mass index are important factors influencing clopidogrel resistance.Detection of CYP2C19 gene polymorphism,diabetes,and body mass index can help guide patients with antiplatelet therapy.