摘要
目的:分析CYP2C19基因多态性对氯吡格雷治疗颈动脉血管内支架置入术(CAS)后患者氯吡格雷抵抗和支架内血栓形成的影响。方法:2014-10—2015-10在本院神经内科诊治的缺血性脑血管病需行CAS治疗的80例患者为研究对象。检测所有患者CYP2C19基因型,分析不同基因型患者所占比率,以及CYP2C19基因发生无功能突变(*2、*3)患者术后经氯吡格雷治疗3个月内氯吡格雷抵抗(CR)发生率和支架内血栓形成发生率的情况。结果:80例患者CYP2C19基因检测结果显示,*1/*2基因型所占比率最高,为37.50%,其次为*1/*1基因型(31.25%)。CYP2C19基因无功能突变(*2、*3)所占比率为68.75%,携带一个无功能突变基因(*1/*2、*1/*3)所占比率为45.00%,同时携带2个无功能突变基因(*2/*2、*2/*3、*3/*3)所占比率为23.75%。术后3个月后CR总发生率为25.00%,支架内血栓形成发生率为16.25%。CYP2C19*2基因携带者(*1/*2、*2/*2)CR发生率和支架内血栓形成发生率均高于CYP2C19*3基因携带者(*1/*3、*3/*3)(P<0.01)。结论:CYP2C19*2基因是影响CAS术后患者CR发生和支架内血栓形成的重要因素,影响患者预后。
Objective:To analyze the value of CYP2C19 gene polymorphism in the regulation of antiplatelet therapy in paitents with carotid artery stenting.Method:80 patients with carotid artery stenting were enrolled in our hospital from October 2014 to October 2015.The incidence of patients with different CYP2C19 genotypes,platelet aggregation rate,clopidogrel resistanceand stent thrombosis were analyzed.Results:In the 80 cases of CYP2C19 gene screening,*1/*2 genotype accounted for the highest rate of 37.50%,followed by*1/*1 genotype was 31.25%.The percentage of nonfunctional mutations(*2,*3)in the CYP2C19 gene was 68.75%,and the ratio of nonfunctional mutant gene(*1/*2,*1/*3)was 45.00%.The percentage of non functional mutant genes(*2/*2,*2/*3,*3/*3)was 23.75%.The overall incidence of clopidogrel resistance was 25.00%and the incidence of thrombosis in the stent after 3 months surgery was 16.25%.The incidence of clopidogrel resistance and the incidence of stent thrombosis in CYP2C19*2(*1/*2,*2/*2)were statistically higher than in CYP2C19*3(*1/*3,*3/*3)(P<0.01).Conclusion:The CYP2C19*2 gene is an important factor in the occurrence of clopidogrel resistance and stent thrombosis in patients with carotid artery stenting,which affects the prognosis of patients.
作者
余建萍
邹显巍
张黎黎
何仲春
马碧
YU Jian-ping;ZOU Xian-wei;ZHANG Li-li;HE Zhong-chun;Ma Bi(First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)
出处
《微循环学杂志》
2019年第3期53-56,共4页
Chinese Journal of Microcirculation
