CYP2C19基因多态性检测指导急性冠脉综合征患者PCI术后抗血小板精准治疗的临床研究

Clinical research of accurate antiplatelet therapy after PCI under CYP2C19 gene polymorphism detection guidance in patients with acute coronary syndrome

目的探讨CYP2C19基因多态性检测指导急性冠脉综合征患者经皮冠状动脉介入(PCI)术后抗血小板精准治疗的临床效果。方法选取2016年1月~2017年9月我院收治的80例急性冠脉综合征患者作为研究对象,采用随机数字表法分为两组,每组各40例。对照组患者实施氯吡格雷与阿司匹林的常规用药,观察组患者实施CYP2C19基因多态性检测指导用药,所有患者均随访6个月,比较两组患者的主要心血管不良事件及主要出血事件。结果观察组患者的主要心血管不良事件发生率低于对照组(P<0.05),两组患者的主要出血事件发生率比较,差异无统计学意义(P>0.05)。结论 CYP2C19基因多态性检测指导急性冠脉综合征患者PCI术后抗血小板精准治疗的效果显著,且不增加出血事件的发生。

Objective To investigate clinical effect of accurate antiplatelet therapy after PCI under CYP2C19 gene polymorphism detection guidance in patients with acute coronary syndrome. Methods A total of 80 patients with acute coronary syndrome treated in our hospital from January 2016 to September 2017 were selected as the subjects, and divided into two groups by random number table method, with 40 cases in each group. The patients in control group received routine use of clopidogrel and aspirin, and patients in observation group used drug under CYP2C19 gene polymorphism detection guidance. The patients were followed up within 6 months, and the incidence of major adverse cardiac events and major bleeding events were compared between the two groups. Results The incidence of major adverse cardiac events in observation group was lower than that in the control group（P〈0.05）. There was not significant difference in incidence of major bleeding events between the two groups. Conclusion Accurate antiplatelet therapy after PCI under CYP2C19 gene polymorphism detection guidance has significant effect on patients with acute coronary syndrome,which dosen′t increase the occurrence of bleeding events.