CYP2C19基因多态性与氯吡格雷抵抗的研究进展

The research progress of CYP2C19 gene polymorphism and clopidogrel resistance

阿司匹林联合氯吡格雷是冠状动脉支架植入术后常规的抗血小板治疗方案。然而,近年来的研究显示接受上述治疗的部分患者血小板的抑制率较低,即氯吡格雷抵抗,与冠脉支架植入术后支架内血栓事件的发生存在因果关系。而导致氯吡格雷抵抗的原因复杂,研究表明CYP2C19基因多态性与其明显相关,对高危人群进行CYP2C19基因多态性检测有利于识别氯吡格雷抵抗,并及时增加氯吡格雷剂量或更换新型血小板P2Y12受体拮抗剂,可降低术后支架内血栓的发生。

Aspirin combined with clopidogrel is a conventional antiplatelet therapy for coronary heart disease after percutaneous coronary intervention.However,recently,studies have shown that the inhibition rate of plate-lets in some patients treated with this therapy is low,which is so called ＆quot;clopidogrel resistance＆quot;,and there is a close relationship between clopidogrel resistance and stent thrombosis events after PCI.Reasons of the clopidogrel resistance is complex.Studies have shown that CYP2C19 gene polymorphism is significantly related with it,and it is well for the high-risk groups of CYP2C19 gene polymorphism to recognize clopidogrel resistance,and in a timely manner increasing the dose of clopidogrel or replacing of the new platelet P2Y12 receptor antagonist,can reduce the incidence of postop-erative stent thrombosis.