氯吡格雷吸收和代谢通路相关基因变异与临床个体化用药实践

Genetic polymorphisms associated with the metabolic pathway of clopidogrel and clinical practice

氯吡格雷是一种新型噻吩吡啶类抗血小板药物,联合应用氯吡格雷及阿司匹林已经成为急性冠脉综合征及经皮冠状动脉介入支架术后患者的标准治疗方案。与氯吡格雷吸收和代谢通路相关的基因变异,使得患者对氯吡格雷的临床反应性存在显著的个体差异,部分患者出现氯吡格雷抵抗现象,增加临床不良事件的发生。确定相关基因变异对指导临床个体化用药实践意义重大。

Clopidogrel is a second-generation thienopyridine which prevents platelet aggregation.Dual antiplatelet therapy including clopidogrel and aspirin is regarded as standard medical care in patients suffering from acute coronary syndromes and in those undergoing percutaneous coronary intervention（PCI） with stent implantation.Data suggests that there is large interindividual variability in clopidogrel effcacy and a part of patients resist clopidogrel,resulting in cardiovascular complications.This article reviews the role of genetic polymorphisms on clopidogrel resistance in order to guide clinical individualized medication.