摘要
目的探讨非心源性TIA患者服用氯吡格雷后短期内缺血性脑卒中复发与CYP2C19基因多态性的关系。方法对82例初发非心源性TIA患者给予氯吡格雷联合阿司匹林治疗21 d,随后氯吡格雷单药治疗,总疗程90 d。根据是否复发缺血性脑卒中将其分为卒中复发组与卒中未复发组,通过CYP2C19基因芯片对两组患者的CYP2C19基因型进行检测。结果卒中复发组39例,卒中未复发组43例。两组患者在年龄、性别、高血压、糖尿病、血脂等的差异均无统计学意义(均P>0.05)。卒中未复发组CYP2C19*1等位基因频率(76.7%)及CYP2C19*1/*1基因型频率(60.5%)显著高于卒中复发组(41.0%,20.5%)(均P<0.01)。卒中未复发组CYP2C19*2等位基因频率(17.4%)及CYP2C19*2/*2基因型频率(2.3%)则显著低于卒中复发组(53.9%,30.8%)(均P<0.01)。两组间其它等位基因及基因型频率的差异无统计学意义(均P>0.05)。卒中未复发组强代谢型的比例显著高于卒中复发组(P<0.001);而弱代谢型的比例却显著低于卒中复发组(P=0.001);两组间中间代谢型的比例差异无统计学意义(P=0.427)。结论非心源性TIA患者服用氯吡格雷后短期内缺血性脑卒中复发与CYP2C19基因多态性有关。
Objective To investigate the relationship between the recurrence of ischemic stroke in short period after taking clopidogrel and the CYP2C19 gene polymorphisms in non-cardiogenic TIA patients. Methods Eightytwo patients with first onset non-cardiogenic TIA were given 21 d of clopidogrel plus aspirin treatment at first,then only clopidogrel treatment,and the total duration of treatment was 90 d. They were divided into stroke recurrence group and non-stroke recurrence group according to whether the ischemic stroke recurred or not. The genotypes of CYP2C19 were detected with CYP2C19 gene chip. Results Stroke recurrence group was 39 cases,and non-stroke recurrence group was 43 cases. There were no significant differences in age,sex,hypertension,diabetes and blood lipids between the two groups（ all P 0. 05）. The CYP2C19＊ 1 allele and CYP2C19＊ 1 / ＊ 1 genotype frequencies of the non-stroke recurrence group（ 76. 7%,60. 5%） were significantly higher than those in stroke recurrence group（ 41. 0%,20. 5%）（ all P 0. 01）. The CYP2C19＊ 2 allele and CYP2C19＊ 2 /＊ 2 genotype frequencies of the nonstroke recurrence group（ 17. 4%,2. 3%） were significantly lower than those in stroke recurrence group（ 53. 9%,30. 8%）（ all P 0. 01）. The other alleles and genotypes frequencies were no significant differences between the two groups（ all P 0. 05）. Extensive metabolizer proportion of the non-stroke recurrence group was significantly higher than that of the stroke recurrence group（ P 0. 001）; while poor metabolizer proportion of the non-stroke recurrence group was significantly lower than that of the stroke recurrence group（ P = 0. 001）; and the intermediate metabolizer proportions between the two groups were of no difference（ P = 0. 427）. Conclusion Recurrence of ischemic stroke in short period in patients taking clopidogrel after the first non-cardiogenic TIA is associated with the mutation of CYP2C19 gene.
出处
《临床神经病学杂志》
CAS
北大核心
2015年第5期334-337,共4页
Journal of Clinical Neurology
