氯吡格雷治疗缺血性脑梗死患者CYP2C19基因多态性疗效的影响

Effect of clopidogrel on CYP2C19 gene polymorphism in patients with ischemic cerebral infarction

目的分析氯吡格雷治疗缺血性脑梗死患者CYP2C19基因多态性对疗效的影响。方法将90例初诊缺血性脑梗死患者纳入研究,采用DNA芯片测定CYP2C19基因多态性,随访患者脑梗死复发情况并分析复发与患者CYP2C19多态性相关性。结果对患者进行1-9个月随访,共规律服用氯吡格雷80例,其中卒中复发17例。中代谢和慢代谢复发率相比于快代谢更高(P<0.05);携带*2A等位基因患者复发率提高,且纯合子高于杂合子(P<0.05);携带失功能(LOF)等位基因患者复发率提高,且携带2个LOF复发率高于1个LOF的患者(P<0.05)。结论服用氯吡格雷对缺血性脑梗死患者二级预防需考察其CYP2C19是否存在LOF等位基因。

Objective To investigate the effect of CYP2C19 polymorphism in patients with ischemic cerebral infarction treated with clopidogrel.Methods 90 patients with preliminary diagnosis of ischemic cerebral infarction were included in the study.CYP2C19 gene polymorphism was detected by DNA chip.The recurrence of cerebral infarction was followed up and the correlation between the recurrence and CYP2C19 polymorphism was analyzed.Results The patients were followed up for one to nine months.And 80 patients were given clopidogrel regularly,17 of them had recurrent stroke.The recurrence rate of middle metabolism and slow metabolism was higher than that of fast metabolism(P<0.05).The recurrence rate of patients with 2A allele increased,and homozygote was higher than heterozygote(P<0.05).The recurrence rate of patients with loss of function(LOF)allele was higher than that of patients with one LOF(P<0.05).Conclusion It is necessary to investigate whether there is allele in CYP2C19 of clopidogrel for secondary prevention of ischemic cerebral infarction.