药物基因组学在氯吡格雷的临床应用进展

Current status of clinical application pharmacogenomics for clopidogrel therapy

氯吡格雷是临床应用最广泛的抗血小板药物,能有效预防或减低动脉血栓及经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后患者心血管事件的发生。众多研究表明,遗传因素在氯吡格雷治疗效果的个体差异中起到了重要作用,使药物基因组学在氯吡格雷抗血小板治疗中的作用受到极大关注。近年来,政策法规机构、临床学术团体以及个体化医疗研究机构等都提出对氯吡格雷的临床应用指导建议。基于药物基因组学指导的氯吡格雷个体化抗血小板治疗还需要更多循证医学证据的支持。

Clopidogrel is the most widely used clinical antiplatelet drug which can prevent artery thrombosis and recurrent cardiovascular events in patients who have undergone percutaneous coronary intervention （PCI）. Several studies indicate that genetic factor plays an important role in individual differences in response to clopidogrel which results in great concerns of pharmacogenomics in elopidogrel antiplatelet therapy. Government, academic institution and research institution of personalized medicine have published recommendations and guidelines of elopidogrel clinical application recently. However, personalized clopidogrel antiplatelet therapy based on pharmacogenomics needs more evidence of evidence-based medicine.