CYP2C19基因多态性与氯吡格雷抵抗的研究现状

Research status of clopidogrel resistance on CYP2C19 gene polymorphism

氯吡格雷是目前治疗急性冠状动脉综合征的一种经典抗血小板药物,能降低冠心病患者尤其是支架术后患者的主要不良心血管事件的风险。但是部分患者存在氯吡格雷抵抗。研究认为,氯吡格雷抵抗受多因素影响,CYP2C19基因多态性是最重要的内部因素。CYP2C19*2和CYP2C19*3是亚洲人群最常见类型,CYP2C19基因变异者,氯吡格雷抗血小板效应减弱,不良心血管事件增加。因此,常规检测CYP2C19基因多态性可指导临床上氯吡格雷个性化用药。

lopidogrel is a classic antiplatelet aggregation drug for acute coronary syndrome,and could reduce the risk of major adverse cardiac events especially after coronary artery stent implantation.However,the phenom-enon of clopidogrel resistance exists in some of these patients.Clopidogrel resistance is related to many possible factors,and CYP2C19gene polymorphism is one of the most important factors.Moreover,CYP2C19＊2and CYP2C19＊3are more common in Asian populations.Among patients treated with clopidogrel,carriers of a reduced-function CYP2C19allele have significantly lower levels of antiplatelet effect and a higher rate of major adverse cardiovascular events.Thus,genotyping for the relevant gene polymorphisms may help to individualize and optimize treatment with clopidogrel.