摘要
目的探讨长期服用氯吡格雷的初发脑梗死患者卒中复发与CYP2C19基因多态性的关系。方法对78例初发脑梗死后长期(≥1 y)服用氯吡格雷的患者,根据入组时是否脑梗死复发分为复发组与未复发组,通过CYP2C19基因芯片检测系统对两组患者的CYP2C19基因型进行检测。结果 78例中,复发组32例,未复发组46例。两组患者在性别、年龄、吸烟、高血压、糖尿病、血脂等的差异均无统计学意义(均P>0.05);所检的78例共检出三种等位基因:CYP2C19*1、CYP2C19*2、CYP2C19*3,等位基因频率分别是61.54%、33.33%、5.13%。两组患者共检出6种基因型:CYP2C19*1/*1、CYP2C19*1/*2、CYP2C19*1/*3、CYP2C19*2/*2、CYP2C19*2/*3和CYP2C19*3/*3。未复发组CYP2C19*1等位基因和CYP2C19*1/*1基因型频率显著高于复发组,分别为76.1%:40.6%(P<0.01),58.7%:18.8%(P<0.001),而未复发组CYP2C19*2等位基因频率和CYP2C19*2/*2基因型频率显著低于复发组,分别为19.6%:53.1%(P<0.01),4.3%:31.3%(P<0.01),而两组其余等位基因频率和基因型频率差异无统计学意义(均P>0.05)。结论长期服用氯吡格雷的脑梗死患者卒中复发与CYP2C19基因突变有关,对于需长期服用氯吡格雷预防脑梗死复发的患者,进行CYP2C19基因型的检测是必要的。
Objective To investigate the relationship between the recurrence of stroke in long-term taking clopidogrel patients after the first attack of cerebral infarction and CYP2C19 gene polymorphisms. Methods 78 long-term（ ≥1year） taking clopidogrel patients after the first attack of cerebral infarction were recruited and divided into two groups according to whether the stroke recured or not. The genotypes of CYP2C19 were detected with CYP2C19 gene chip. Results Of the 78 patients,32 were in the stroke recured group,46 were in the non-stroke recured group. There were no significant differences in sex,age,smoking,hypertension,diabetes,and blood lipids（ all P 0. 05）. In the 78 patients,three alleles of CYP2C19 were detected： CYP2C19 ＊ 1、CYP2C19 ＊ 2 and CYP2C19 ＊ 3,the frequencies of them were 61. 54% 、33. 33% and 5. 13%,respectively,and six genotypes of CYP2C19 were detected as CYP2C19＊ 1 / ＊ 1、CYP2C19＊ 1 / ＊ 2、CYP2C19＊ 1 / ＊ 3、CYP2C19＊ 2 / ＊ 2、CYP2C19＊ 2 / ＊ 3 and CYP2C19 ＊ 3 / ＊ 3. The CYP2C19 ＊ 1 allele and CYP2C19＊ 1 / ＊ 1 genotype frequencies of the non-stroke recured group were significantly higher than those of the stroke recured group（ 76. 1% vs. 40. 6%,P 0. 01; 58. 7% vs. 18. 8%,P〈 0. 001）,and the CYP2C19＊ 2 allele and CYP2C19＊ 2 / ＊2 genotype frequencies of the non-stroke recured group were significantly lower than those of the stroke recured group（ 19. 6% vs. 53. 1%,P 〈0. 01; 4. 3% vs. 31. 3%,P 〈0. 01）. Other alleles and genotypes frequencies were not significant differences different between the 2 groups（ all P 〉0. 05）. Conclusion The recurrence of stroke in long-term taking clopidogrel patients after the first attack of cerebral infarction was associated with the mutation of CYP2C19 gene. Routine CYP2C19 testing may be warranted.
出处
《中风与神经疾病杂志》
CAS
北大核心
2015年第1期41-44,共4页
Journal of Apoplexy and Nervous Diseases
