不同CYP2C19基因型急性缺血性脑卒中患者复发相关因素的研究

A study on the related factors of recurrence in acute ischemic stroke patients with different CYP2C19 genotypes

目的探讨不同CYP2C19基因型急性缺血性脑卒中（AIS）患者复发的独立相关因素。方法回顾性分析601例完善CYP2C19基因多态性检测的AIS患者资料，根据不同CYP2C19基因型分为快、中和慢代谢3个独立大组，进一步将每个大组依据随访有无缺血性卒中复发分为复发组和非复发组，收集临床资料，分析与复发的相关性。结果将每个大组中差异有统计学意义的因素带入Logistic回归分析后，快代谢组中自蛋白（P=0．036），中代谢组甘油三酯（P=0．036）和胱抑素C（P=0．044），慢代谢组血糖（P=0．040）和游离三碘甲状腺原氨酸（P=0．025）对复发的影响有统计学意义（P〈0．05）。结论CYP2C19不同基因型AIS患者复发的相关因素不同；白蛋白是CYP2C19快代谢AIS患者复发的保护因素；甘油三酯与胱抑素C是CYP2C19中代谢AIS患者复发的危险因素；血糖与低水平游离三碘甲状腺原氨酸是CYP2C19慢代谢AIS患者复发的危险因素。

Objective To investigate the independent factors associated with the recurrence of acute ischemic stroke （AIS） patients with different CYP2C19 genotypes. Methods Retrospective analysis was performed using clinical data from AIS 601 patients who underwent complete detection of CYP2C19 gene polymorphism. According to their different genotypes of CYP2C19, the patients were divided into a fast, an intermediate and a slow metabolism group. Based on the results of follow - up visits, each group was further subdivided into a recurrence group and a non - recurrence group. Their correlation with the recurrence of AIS was analyzed. Results According to Logistic regression analysis, albumin in the fast metabolism group （P =0.036）, triglyceride （P =0. 036） and cystatin C （P =0. 044） in the intermediate metabolism group, and blood glucose （ P = 0.040） and free triiodothyronine （ P = 0.025） in the slow metabdism group were associated with recurrence （P 〈 0.05）. Conclusions AIS patients with different CYP2C19 genotype demonstrate various related factors of recurrence. Albumin is a protective factor for recurrence in AIS patients with fast metabolism of CYP2C19. Triglyceride and cystatin C are risk factors of recurrence in AIS patients with intermediate metabolism of CYP2C19. Blood glucose and low levels of free triiodothyronine are risk factors of recurrence in AIS patients with slow metabolism of CYP2C19.