汉族脑梗死患者中氯吡格雷抵抗的相关因素研究

Related factors of clopidogrel resistance( CR) in Han patients with cerebral infarction

目的探讨汉族脑梗死患者中氯吡格雷抵抗的相关因素。方法测定103例汉族脑梗死患者的血小板聚集率,分为氯吡格雷抵抗组和有效组,进行药物剂量、胰岛素抵抗、年龄、吸烟、高血压等因素的资料收集,并测定CYP2C19和P2Y12基因多态性,最后进行统计学分析。结果在氯吡格雷有效组和抵抗组,胰岛素抵抗差异无统计学意义(P>0.05),两组间性别、抽烟、高血压、血脂、BMI差异也无显著性(P>0.05),而氯吡格雷剂量、两种基因多态性均有统计学差异(P<0.05)。结论在汉族脑梗死患者中,氯吡格雷剂量、CYP2C19和P2Y12基因多态性是氯吡格雷抵抗的独立危险因素。而胰岛素抵抗、年龄、性别、抽烟、高血压、血脂、BMI与氯吡格雷抵抗可能无关。

Objective To explore the related factors of clopidogrel resistance（CR） in Han patients with cerebral infarction. Methods A total of 103 Han patients with cerebral infarction were divided into resistance group and effective group according to the platelet ag- gregation rate. The data of drug dose, insulin resistance （ IR）, age, smoking, hypertension, and other risk factors were collected. The gene polymorphisms of CYP2C19 and P2Y12 were detected and analyzed. Results There was no statistical difference in IR, sex, smoking, hypertension, blood fat, BMI between resistance group and effective group（ P 〉 0.05 ）. The drug doses of clopidogrel and gene polymorphisms of CYP2C19 and P2Y12 were statistically different between two groups（ P 〈 0. 05 ）. Conclusion In Han patients with cerebral infarction, the doses of clopidogrel and the gene polymorphisms of CYP2C19 and P2Y12 are independent risk factors of CR, but IR, age, sex, smoking, hypertension, blood fat, BMI are not related to CR.