摘要
目的通过比较不同患者CYP2C19基因多态性及脑梗死危险因素与氯吡格雷抵抗的关系，明确CYP2C19基因多态性及脑梗死危险因素在预测氯吡格雷抵抗发生中的作用。方法利用光学比浊法检测80例缺血性脑血管病患者使用氯吡格雷前后的血小板聚集率（RPA），直接测序法检测人选患者的CYP2C19基因型，分析产生氯吡格雷抵抗可能的影响因素。结果氯吡格雷敏感者RPA〈70％为58例（72．5％）；氯吡格雷抵抗者RPA≥70％为22例（27．5％）。CR组患者的体重指数（BMI）、合并糖尿病及CYP2C19基因突变者明显高于NCR（P〈0．05），Logistic多元回归分析结果提示，与非氯吡格雷抵抗组相比，体重指数、糖尿病及CYP2C19突变基因与氯吡格雷抵抗相关（P〈0．05）。结论部分缺血性脑血管病患者确实存在氯吡格雷抵抗，其影响因素是多方面的。体重指数、糖尿病及CYP2C19突变基因可能是其危险因素。
Objective To compare the correlations of clopidogrel resistance with CYP2C19 gene polymorphism and cerebral infarction risk factors, and assess CYP2C19 gene polymorphism and cerebral infarction risk factors in predicting clopidogrel resistance. Methods Using optical turbidimetric method to detect the platelet aggregation rate of the 80 patients with Ischemic cerebrovascular disease before and after the use clopidogrel. Detect CYP2C19 genotype of selected patients by direct sequencing method. Investigate the influencing factors of CR in the cerebral infarction patients. Results The number of the clopidogrel sensitive （ RPA 〈 70% ） was 58, the proportion was 72.5%. The number of the clopidogrel resistance （RPA 〉 70% ） is 22, the proportion was 27.5 %. Patients carry the wild type allele （ ＊ 1/＊ 1 ）, the proportion of 32.5%. 37 cases of the patients carry the The number of high body mass index,diabetes mellitus and CYP2C19 mutatitions in CR group is higher than NCR group（P 〈 0.05）. Logistic multivariate regression analysis showed that Compared with the NCR group, body mass index, diabetes and CYP2C19 mutations associated with CR heightly. Conclusion A number of patients exist clopidogrel resistance. Body mass index,diabetes and CYP2C19 mutations may be risk factors for it.
出处
《临床内科杂志》
CAS
2016年第1期22-24,共3页
Journal of Clinical Internal Medicine
基金
武汉市临床医学科研项目（WX15C15）
长江航运管理局科技项目（201310015）
