摘要
氯吡格雷近年来广泛应用于冠心病患者的抗血小板治疗,但其疗效存在明显的个体差异,氯吡格雷抵抗患者发生重大不良心血管事件的风险增加。氯吡格雷抗血小板活性与基因多态性相关,ATP结合转运蛋白B1、羧酸酯酶1、细胞色素P4502C19酶、对氧磷脂酶1和血小板ADP受体P2Y12等的编码基因可分别调控氯吡格雷体内吸收、转化、转运等生物过程及P2Y12受体合成,从而影响其抗血小板作用。通过检测分析特定基因多态性,明确突变基因对氯吡格雷药动学及药效学的影响,可为指导冠心病患者个体化抗血小板治疗提供依据。
Clopidogrel has been widely used for antiplatelet therapy in patients with coronary heart disease in recent years,but obvious individual differences have been observed in its efficacy.Patients with clopidogrel resistance have an increased risk of major adverse cardiovascular events.Clopidogrel anti-platelet activity is associated with gene polymorphism.The coding genes for ATP-binding cassette B1,carboxylesterase 1,ytochrome P4502C19,paraoxonase 1 and platelet ADP receptor P2Y12 can regulate the biological processes of clopidogrel absorption,transformation,transport and the synthesis of P2Y12 receptor,thus affecting its antiplatelet effect.Through the analysis of specific gene polymorphisms,to clarify the effect of mutant genes on the pharmacokinetics and pharmacodynamics of clopidogrel,a basis for guiding individualized antiplatelet therapy in the patients with coronary heart disease can be provided.
作者
丁柏宇
赵军礼
DING Baiyu;ZHAO Junli(Shanghai No.1 College of Clinical Medicine,Nanjing Medical University,Nanjing 210000,China;Department of Car-diology,Shanghai First People′s Hospital,Shanghai 200080,China)
出处
《医学综述》
2020年第19期3801-3805,3813,共6页
Medical Recapitulate
关键词
氯吡格雷
氯吡格雷抵抗
基因多态性
个体化治疗
Clopidogrel
Clopidogrel resistance
Genetic polymorphisms
Individualized therapy
