摘要
目的探讨MTHFR A1298C基因突变对PCI术后患者应用叶酸降低同型半胱氨酸(Hcy)的效果及主要不良心血管事件(MACE)的影响。方法选择300例合并HHcy(高同型半胱氨酸血症)的PCI术后患者,依据MTHFR A1298C基因检测结果分为观察组(未突变组)和对照组(突变组)。两组患者均在PCI术后常规治疗基础上给予叶酸片降低Hcy治疗。所有患者随访6个月。记录患者应用叶酸治疗前及治疗后3、6个月血浆Hcy的变化,计算两组患者治疗6个月时降低血浆Hcy治疗的有效率。观察两组MACE发生情况。结果观察组187例患者(62.3%),对照组113例患者(37.7%)。服用叶酸3、6个月时,观察组患者血浆Hcy分别为(21.5±4.6)、(14.2±3.8)μmol/L,显著低于对照组的(28.8±7.3)、(17.6±8.4)μmol/L,差异有统计学意义(P<0.05)。服用叶酸治疗6个月,观察组患者降低Hcy治疗的有效率高于对照组(77.5%vs.61.1%),差异有统计学意义(P<0.05)。观察组MACE发生率略低于对照组(9.1%vs.13.3%),但差异无统计学意义(P>0.05)。结论 MTHFR A1298C基因突变会减弱PCI术后患者应用叶酸降低血浆Hcy的治疗效果,对MACE发生率无显著影响。
Objective To investigate the effect of MTHFR A1298C gene mutation on the efficacy of folic acid for lowering homocysteine and MACE in patients after PCI.Methods Totally 300 patients complicated with HHcy after PCI were divided into observation group(non-genetic mutation group)and control group(genetic mutation group),according to the results of MTHFR A1298C gene detection.All the patients were treated with folic acid tablets to reduce Hcy on the basis of conventional treatment after PCI,and were followed up for 6 months.The changes in plasma Hcy were recorded before and at 3 and 6 months after treatment of folic acid.The effective rate of lowing Hcy of patients was calculated at 6 months after treatment.The occurrence of MACE in both groups was observed.Results There were 187 cases(62.3%)in observation group and 113 cases(37.7%)in control group.After taking folic acid for 3 and 6 months,the plasma Hcy in observation group was(21.5 ± 4.6)and(14.2 ± 3.8)μmol/L respectively,which was significantly lower than that of control group[(28.8 ± 7.3)and(17.6 ± 8.4)μmol/L,P<0.05].After taking folic acid for 6 months,the effective rate of lowing Hcy in observation group was higher than that in control group(77.5% vs.61.1%,P<0.05).The incidence rate of MACE in observation group was slightly lower than that in control group(9.1% vs.13.3%),but the difference was not statistically significant(P>0.05).Conclusion The mutation of MTHFR A1298C gene may reduce the effect of folic acid on plasma Hcy in patients after PCI,but it has no significant effect on the incidence of MACE.
作者
郭树领
徐炳欣
赵艳
王喜红
GUO Shu-ling;XU Bing-xin;ZHAO Yan;WANG Xi-hong(Department of Cardiovascular Medicine,Xuchang Central Hospital,Xuchang 461000,China;Department of Pharmacy,Xuchang Central Hospital,Xuchang 461000,China;Xuchang Key Laboratory of Drug Clinical Research of Cardiovascular Agents,Xuchang 461000,China)
出处
《实用药物与临床》
CAS
2019年第4期378-381,共4页
Practical Pharmacy and Clinical Remedies
基金
河南省科技攻关计划项目(182102310214)
