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冠状动脉性心脏病合并高血压患者CYP2C19基因多态性及不同基因型与氯吡格雷抵抗的关系研究 被引量:4

Relationship between CYP2C19 gene polymorphism and different genotypes and clopidogrel resistance in patients with coronary heart disease complicated with hypertension
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摘要 目的分析冠状动脉性心脏病(冠心病)并高血压患者的CYP2C19基因多态性和氯吡格雷抵抗之间的相关性。方法抽取2018年1月至2019年2月郑州大学附属郑州中心医院收治的112例冠心病患者作为回顾分析对象,根据合并高血压与否分为观察组(62例,合并高血压)和对照组(50例,未合并高血压)。对比两组患者CYP2C19基因多态性分布情况、氯吡格雷抵抗发生情况,以及观察组中不同CYP2C19基因多态性患者氯吡格雷抵抗分布情况。结果两组血常规、总胆红素、血脂以及清蛋白等指标比较差异未见统计学意义(P>0.05);观察组血肌酐水平低于对照组(P<0.05),协方差法显示患者是否合并高血压疾病和肌酐指标之间并不具备交互作用(P>0.05);两组患者的不同代谢基因型比例比较差异未见统计学意义(P>0.05);观察组氯吡格雷抵抗率为53.23%,对照组为46.00%,两组比较差异未见统计学意义(P>0.05)。观察组中,慢、中代谢基因型组的氯吡格雷抵抗率高于快代谢基因型组(P<0.05);在发生氯吡格雷抵抗的33例患者中,CYP2C19慢代谢基因型冠心病合并高血压患者的氯吡格雷抵抗率(86.67%)高于中代谢基因型(54.55%)、快代谢基因型(14.29%)患者,差异有统计学意义(P<0.05)。结论冠心病患者的CYP2C19基因多态性、氯砒格雷抵抗均与其合并高血压与否并无相关性,然而氯吡格雷抵抗与CYP2C19基因多态性具有相关性。 Objective To analyze the correlation between CYP2C19 gene polymorphism and clopidogrel resistance in patients with coronary heart disease and hypertension.Methods A total of 112 patients with coronary heart disease admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2018 to February 2019 were enrolled in the study.The patients were divided into the observation group(62cases,combined with hypertension)and the control group(50 cases,without hypertension)by hypertension occurrence.The distribution of CYP2C19 gene polymorphism was compared between the patients with coronary heart disease complicated with hypertension and the patients with coronary heart disease without hypertension.The incidence of clopidogrel resistance in the two groups were compared,too.Moreover,the distribution of clopidogrel resistance in patients with different CYP2C19 gene polymorphisms in the observation group were observed.Results There was no significant difference in blood routine,total bilirubin,blood lipid and albumin between the two groups(P>0.05).The creatinine level in the observation group was lower than that in the control group(P<0.05),there was no interaction between hypertension and creatinine index according to covariance(P>0.05).There was no significant difference in the proportion of different metabolic genotypes between the two groups(P>0.05).The resistance of clopidogrel was 53.23%in the observation group,and 46.00%in the control group,however,there was no significant difference between the two groups(P>0.05).In the observation group,the resistance rate of clopidogrel in the slow and medium metabolic genotype group was higher than that in the fast metabolism genotype group(P<0.05);chlorine occurred in the observation group.Among the 33 patients with pirogram resistance,the clopidogrel resistance rate of CYP2C19 slow-metabolic genotype with coronary heart disease and hypertension was significantly higher(86.67%)than the middle metabolic genotype(54.55%)and fast metabolizing genotype(14.29%),the difference was statistically significant(P<0.05).Conclusions Coronary heart disease patients with CYP2C19 gene polymorphism,chlorhexidine resistance are not associated with hypertension,but clopidogrel resistance is correlated to CYP2C19 gene polymorphism.
作者 郭玉梅 张琳 李海洲 苏荏 Guo Yumei;Zhang Lin;Li Haizhou;Su Ren(Department of Cardiology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)
出处 《中国实用医刊》 2019年第23期14-17,共4页 Chinese Journal of Practical Medicine
基金 河南省医学科技攻关计划(201602330)。
关键词 冠心病 高血压 氯吡格雷 基因多态性 抵抗 Coronary heart disease Hypertension Clopidogrel Gene polymorphism Resistance
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