中国沈阳地区汉族冠心病患者CYP2C19基因多态性分布特征

Distribution Characteristics of CYP2C19 Gene Polymorphism in Han Patients with Coronary Heart Disease in Shenyang,China

目的探讨沈阳地区汉族冠心病(coronary heart disease,CHD)患者细胞色素P450 2C19(CYP2C19)基因多态性分布特征。方法选取2016年1月～2018年1月于北部战区总医院(原沈阳军区总医院)入院接受治疗的冠心病患者2 748例,应用聚合酶链反应微阵列芯片杂交方法检测患者氯吡格雷代谢相关的CYP2C19基因型。根据性别、年龄因素对患者进行分组。采用四格表资料的χ~2检验,R×C表资料的χ~2检验比较各组间冠心病患者氯吡格雷代谢相关的CYP2C19*1,*2,*3基因型,*2,*3等位基因频率,及氯吡格雷代谢型的分布差异。结果沈阳地区汉族冠心病患者CYP2C19*1/*1,CYP2C19*1/*2,CYP2C19*1/*3,CYP2C19*2/*2,CYP2C19*3/*3和CYP2C19*2/*3发生率分别为41.7%,39.3%,5.8%,9.8%,0.4%和3.0%;CYP2C19*2,CYP2C19*3等位基因频率分别为31.0%和4.8%;氯吡格雷快代谢型(EM),氯吡格雷中间代谢型(IM),氯吡格雷慢代谢型(PM)发生率分别为41.7%,45.1%和13.2%。根据性别分组,患者CYP2C19*2,*3等位基因,氯吡格雷代谢型,CYP2C19的6种基因型在不同性别冠心病患者中的分布差异均无统计学意义(χ~2=0.032～9.205,均P>0.05)。根据年龄分组<45岁,45～59岁,60～75岁,>75岁,患者CYP2C19*2,*3等位基因,CYP2C19的6种基因型在不同年龄冠心病患者中的分布差异均有统计学意义(χ~2=17.718～48.772,均P≤0.001),氯吡格雷代谢型在不同年龄冠心病患者中的分布差异无统计学意义(χ~2=4.442,P=0.617)。结论沈阳地区汉族冠心病患者CYP2C19的6种基因型,CYP2C19*2,*3等位基因分布与沈阳地区汉族冠心病患者性别差异无关,与年龄分层密切相关。

Objective To investigate the distribution of Cytochrome P450 2C19(CYP2C19)gene polymorphism in Han patients with coronary heart disease(CHD)in Shenyang.Methods The genotype of CYP2C19related to clopidogrel metabolic was detected by polymerase chain reaction microarray hybridization in 2 748Han patients with coronary heart disease admitted to the Northern Theater Command General Hospital from January 2016to January 2018.The patients were grouped according to gender and age.Chi-square test was adopted to analysis the six differences of CYP2C19genotypes,allele distribution of*2and*3in different age and sex CHD patients.Results The frequencies of CYP2C19*1/*1,CYP2C19*1/*2,CYP2C19*1/*3,CYP2C19*2/*2,CYP2C19*3/*3and CYP2C19*2/*3in Han patients with coronary heart disease in Shenyang,China were 41.7%,39.3%,5.8%,9.8%,0.4%and 3.0%respectively,the frequencies of CYP2C19*2 and CYP2C19*3alleles were 31.0%and 4.8%respectively,extensive metabolizers(EM),intermediate metabolizers(IM)and poor metabolizers(PM)were 41.7%,45.1%and 13.2%respectively in Han patients with CHD in Shenyang.There was no statistically significant in the distribution of CYP2C19*2and*3alleles,clopidogrel metabolic type and CYP2C19 genotypes among patients of different gender with coronary heart disease(χ^2=0.032~9.205,all P>0.05).There was statistically significant in the distribution of CYP2C19*2,*3allele and CYP2C19genotypes in patients of different ages with coronary heart disease was significantly different according to age groups<45y,45~59y,60~75y and>75y(χ^2=17.718~48.772,all P≤0.001).There was no statistically significant in the distribution of patients and clopidogrel metabolic type in patients with coronary heart disease at different ages(χ^2=4.442,P=0.617).Conclusion The distribution of CYP2C19*2,*3alleles and 6genotypes of CYP2C19in CHD patients of Han nationality in Shenyang area was related with age,and not related with gender.