支架内血栓与CYP2C19*2、CYP2C19*3基因多态性的相关性研究

Relationship between stent thrombosis and gene polymorphism of CYP2C19*2,CYP2C19*3

目的探讨冠脉介入治疗后支架内血栓形成与CYP2C19基因多态性的相关性。方法回顾性单中心研究，入选2000～2015年首都医科大学附属北京安贞医院急性冠脉综合征患者120例，其中，冠脉介入术后支架内血栓形成（ST组）40例，对照组80例为冠脉介入术后支架内未形成血栓。给予充分氯吡格雷治疗后，进行基因多态性检测。结果CYP2C19＂2基因分布（GIG、A／A、G／A）在ST组中为5例（12．5％）、30例（75．0％）、5例（12．5％），对照组为37例（46．2％）、42例（52．5％）、1例（1．3％）；携带等位基因A突变率为87．50％比53．75％（P〈0．05）。CYP2C19＊3基因分布（G／G、～A、G／A）在ST组中为39例（97．5％）、1例（2．5％）、0例（0．0％），对照组为80例（100．0％）、0例（0．0％）、0例（0．0％）；携带等位基因A突变率为2．5％比0．0（P〉0．05）。ST组与对照组相比低密度脂蛋白水平差异有统计学意义（P〈0．05）。结论支架内血栓形成与CYP2C19＊2基因突变有相关性，支架内血栓形成与CYP2C19＊3基因突变关系尚不明确，低密度脂蛋白水平升高可以影响支架内血栓形成。

Objective To investigate the relationship of coronary intervention stent thrombosis with CYP2C19 gene polymorphism. Methods As retrospective single center study, a total of 120 patients with acute coronary syndrome from 2000 to 2015 in Beijing Anzhen Hospital, Capital Medical University were selected. 40 patients had coronary intervention stent thrombosis were taken as the ST group. 80 patients without stent thrombosis after percutaneous coronary in- tervention were taken as the control group. After the patients received adequate Clopidogrel pretreatment, all of them were accepted detection of gene polymorphism. Results G/G, A/A , G/A genotype frequencies of CYP2C19＊2 were 5 cases （12.5%）, 30 cases （75.0%）, 5 cases （12.5%） in the ST group; which were 37 cases （46.2%）, 42 cases （52.5%）, 1 case （1.3%） in the control group; the mutation rate of A was 87.5% vs 53.75% （P 〈 0.05）. G/G, A/A, G/A genotype frequencies of CYP2C19＊3 were 39 cases （97.5%）, 1 case （2.5%）, 0 case （0.0%） in the ST group; which were 80 cases （100.0%）, 0 case （0.0%）, 0 case （0.0%） in the control group; the mutation rate of A was 2.5% vs 0.0% （P 〉 0.05）. The level of low density lipoprotein had significantly statistically difference between the ST group and the control group （P 〈 0.05）. Conclusion Stent thrombosis has correlation with CYP2C19＂2 gene mutations, but the relationship of stent thrombosis with CYP2C19＊3 gene mutations is still unclear. Low density lipoprotein levels can affect stent thrombosis.