冠脉介入术患者CYP2C19基因多态性与氯吡格雷应用后心血管事件的相关性研究

Correlation between CYP2C19 Polymorphism and Cardiovascular Events in Patients with Coronary Heart Disease After Treatment by Clopidogrel

目的:研究中国淮海地区汉族人群中冠心病并行支架植入术患者CYP2C19基因多态性与氯吡格雷应用后心血管事件发生的相关性。方法:选取我院拟行冠脉介入术治疗的冠心病患者225例,采用芯片杂交法进行CYP2C19基因分型。观察患者在服用氯吡格雷等药物治疗1年内各种心脑血管事件和出血事件的发生情况。结果:所有患者中CYP2C19基因慢代谢型比例为13.33%,中间代谢型比例为40.89%,快代谢型比例为45.78%。CYP2C19基因慢代谢型患者中发生心血管事件5例,快代谢型患者无心血管事件发生,差异有统计学意义(P<0.05)。Logistic多元回归分析,发生心血管事件的相关因素为CYP2C19突变杂合及纯合基因型、吸烟、低密度脂蛋白过高(P<0.05)。结论:淮海地区PCI术患者CYP2C19基因突变与氯吡格雷应用后再发生心血管事件相关。

This study is to investigate the correlation between CYP2C19 gene polymorphism and cardiovascular events in patients of coronary heart disease who accepted clopidogrel treatment after percutaneous coronary intervention（PCI）.A total of 225 patients of Chinese Han population in Huaihai area were enrolled.The genetic polymorphism of CYP2C19 was detected by DNA chip hybridization.The occurrence of cardiovascular and cerebrovascular events and bleeding events during one year of clopidogrel therapy was observed.Among all the patients,8,17 and 7 cases of cardiovascular events were found in slow metabolizers,intermediary metabolizers and extensive metabolizers of CYP2C19,respectively（P〈0.05）.Logistic regression analysis showed that CYP2C19 gene polymorphism,smoking and high low-density lipoprotein level were correlative factors for cardiovascular events（P〈0.05）.There is correlation between CYP2C19 polymorphism and recurrent cardiovascular events in patients who accepted clopidogrel treatment after PCI of Chinese Han population in Huaihai area.