摘要
目的研究不同年龄段CYP2C19基因多态性与氯吡格雷抵抗(clopidogrel resistance,CR)发生的相关性。方法 142例急性冠脉综合症(acute coronary syndrone,ACS),患者入选本研究,给予氯吡格雷及阿司匹林口服,并测定5μmol.L-1腺苷二磷酸诱导的血小板聚集率(platolet aggregationrate,PAR)>50%定义为CR。采用聚合酶链反应结合限制性片段长度多态性(polymerase chain re-action-restriction fragment length polymorphism,PCR-RFLP)分析法检测CYP2C19*2及CYP2C19*3基因多态性。分为<65岁及≥65岁2个年龄组进行统计分析。结果 142例患者中,纯合子强代谢型(*1/*1)47例(33.1%),杂合子强代谢型(*1/*2,*1/*3)70例(49.3%),弱代谢型(*2/*2,*2/*3)25例(17.6%),3种代谢组中出现CR的概率分别为31.9%、37.1%和68.0%(P<0.01)。这种差异在<65岁组中更为显著(P<0.01),而在≥65岁组未发现统计学差异(P>0.05)。结论在<65岁的患者中CYP2C19基因多态性与CR的发生具有相关性。
Objective To investigate the association between the gene polymorphism of cytochrome P450 CYP 2C19 and the occurrence of clopidogrel resistance（CR）among the age groups.Methods A total of 142 patients with acute coronary syndrome（ACS）were enrolled.After the loading doses of 300 mg clopidogrel and 300 mg aspirin,all patients received clopidogrel 75 mg·d-1 and aspirin 100 mg·d-1.5 μmol·L-1 ADP-induced platelet aggregation ratio（PAR）was assessed 24 h after undergoing coronary angiography or intervention treatment（PCI）.PAR50% was defined as CR.CYP2C19＊2 and CYP2C19＊3 genotype were identified by polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP）.The patients were divided into two age groups：65 year-old group and ≥65 year-old group,and the parameters were analyzed using SPSS 11.5 software.Results Of the patients included,47（33.1%）were homEMs（＊1/＊1）,70（49.3%）were hetEMs（＊1/＊2 or ＊1/＊3）,and 25（17.6%）were PMs（＊2/＊3 or ＊2/＊2）.The incidence rate of CR were 31.9%,37.1% and 68.0% respectively（P0.01）.The difference was more significant among the patients younger than 65 years old（P0.01）,but there was no statistically significant difference among the patients older than 65 years old（P0.05）.Conclusions CYP2C19 gene polymorphism is associated with the risk of CR in patients younger than 65 years old.
出处
《沈阳药科大学学报》
CAS
CSCD
北大核心
2011年第4期320-324,共5页
Journal of Shenyang Pharmaceutical University
