PCI患者CYP2C19基因检测指导抗血小板方案

Detection of CYP2C19 Gene in PCI Patients to Guide Antiplatelet Program

目的探讨PCI患者CYP2C19基因检测指导抗血小板方案。方法选择200例PCI患者,根据CYP2C19基因检测结果分为观察组和对照组,对照组采用常规氯吡格雷治疗,观察组根据患者个体代谢情况,分别给予氯吡格雷+阿司匹林+替格瑞洛组合治疗。对比两组患者的不良反应发生率、血小板抑制率、血小板凝聚率、冠状动脉病变分布情况。结果 (1)对比两组患者术后心血管不良事件:观察组与对照组不良反应发生率对比(P>0.05),无统计学意义;而观察组的总体MACE(不良心血管发生率)显著低于对照组(P<0.05),差异具有统计学意义;(2)血小板抑制率对比:血小板抑制率显著高于对照组(P<0.05),有统计学意义;(3)血小板聚集率对比:观察组明显优于对照组相比(P<0.05),差异有统计学意义;(4)两组患者冠状动脉病变分布情况比较:观察组与对照组无显著差异(P>0.05)。结论临床治疗中可以充分在实施PCI术后进行CYP2C19的基因检测,能够显著改善ACS患者的抗血小板治疗近期治疗,但远期预后效果,仍需要进行临床研究。

Objective To investigate the effect of CYP2C19 gene detection on antiplatelet therapy in patients with PCI.Methods Two hundred patients with PCI were selected and divided into observation group and control group according to CYP2C19 gene detection results.The control group was treated with conventional clopidogrel,and the observation group was given clopidogrel + aspirin + ticagrelor combination treatment according to the individual metabolism of patients.The incidence of adverse reactions,platelet inhibition rate,platelet aggregation rate and coronary artery disease distribution were compared between the two groups.Results (1) Comparison of two groups of patients with postoperative cardiovascular adverse events:the incidence of adverse reactions between the observation group and the control group (P>0.05),was not statistically significant.While the overall MACE (incidence of adverse cardiovascular events) of the observation group was significantly lower than that of the control group (P<0.05),and the difference was statistically significant.(2) Comparison of platelet inhibition rate:the platelet inhibition rate was significantly higher than that of the control group (P<0.05),statistical significance.(3) Comparison of platelet aggregation rate:the observation group was significantly better than the control group (P<0.05),the difference was statistically significant.(4) Comparison of coronary artery lesion distribution between the two groups:there was no significant difference between the observation group and the control group (P>0.05).Conclusion CYP2C19 gene detection can be fully carried out after PCI in clinical treatment,which can significantly improve the short-term treatment of antiplatelet therapy in ACS patients,but the long-term prognosis still needs clinical research.