血小板内皮聚集受体1基因多态性与阿司匹林抵抗及心血管事件发生相关性研究

The relationship between platelet endothelial aggregation receptor 1 gene polymorphism with aspirin resistance and cardiovascular events

目的探讨血小板内皮聚集受体1(PEAR1)基因多态性与阿司匹林抵抗及心血管事件的相关性。方法选取自2018年1月至2019年12月于北部战区总医院就诊的340例缺血性心血管疾病患者为研究对象。所有患者均服用阿司匹林100 mg, 1次/d,至少7 d。检测PEAR1基因rs12041331位点多态性,分为野生型(GG组)、突变杂合型(GA组)、突变纯合型(AA组)。随访1年,比较3组治疗前后花生四烯酸诱导的血小板聚集率水平及心血管事件发生情况。结果治疗后,GG组与GA组的血小板聚集率比较,差异无统计学意义(P>0.05);GG组、GA组血小板聚集率均低于AA组,组间比较,差异均有统计学意义(P<0.05);且治疗后,GG组、GA组的血小板聚集率均低于治疗前,差异有统计学意义(P<0.05)。随访1年,GG组、GA组、AA组的心血管事件发生率分别为18.1%(23/127)、26.0%(38/146)、37.3%(25/67)。GG组心血管事件发生率低于GA组、AA组,且GA组低于AA组,组间比较,差异均有统计学意义(P<0.05)。结论缺血性心血管疾病患者PEAR1基因rs12041331位点多态性与服用阿司匹林后血小板聚集率和心血管事件发生率有关。PEAR1基因rs12041331位点GG型对阿司匹林的应答性最好,GA型应答性一般,AA型对阿司匹林存在抵抗,影响预后。该基因位点基因的检测对个体化抗血小板治疗具有重要临床意义。

Objective To investigate the relationship betweenplatelet endothelial aggregation receptor 1(PEAR1)gene polymorphism with aspirin resistance and cardiovascular events.Methods A total of 340 patients with ischemic cardiovascular disease admitted to the General Hospital of Northern Theater Command from January 2018 to December 2019 were selected as the study subjects.All patients received aspirin 100 mg once a day for at least 7 days.The polymorphism of rs12041331 of PEAR1 gene was detected and divided into wild type(GGgroup),mutant heterozygous(GAgroup)and mutant homozygous(AAgroup).The platelet aggregation rate induced by arachidonic acid and the incidence of cardiovascular events in the three groups were compared before and after treatment for 1 year.Results After treatment, there was no significant difference in platelet aggregation rate between GG group and GA group(P>0.05),and the platelet aggregation rate in GG group and that in GA group were lower than that in AA group, with statistical significance among groups(P<0.05).After treatment, the platelet aggregation rate of GG group and GA group was lower than that before treatment, the difference was statistically significant(P<0.05).Follow-up of 1 year, the incidence of cardiovascular events in GG group, GA group and AA group was 18.1%(23/127),26.0%(38/146)and 37.3%(25/67),respectively.The incidence of cardiovascular events in GG group was lower than that in GA group and AA group, and the incidence in GA group was lower than that in AA group, with statistical significance among groups(P<0.05).Conclusion The polymorphism of rs12041331 of the PEAR1 gene in patients with ischemic cardiovascular disease is associated with platelet aggregation and cardiovascular events after aspirin administration.The response of the GG type to aspirin was the best, the response of the GA type was general, and the AA type was resistant to aspirin, which affected theprognosis.The detection of rs12041331 in PEAR1 gene has great clinical significance for individualized antiplatelet therapy.