CYP2C19基因多态性对少数民族患者氯吡格雷个性化治疗的影响

Effects of CYP2C19 gene polymorphism on individualized therapy of clopidogrel in minority patients

目的探讨CYP2C19基因多态性对少数民族患者氯吡格雷个体化用药的影响。方法选取该院少数民族心脑血管疾病患者189例,采用荧光免疫杂交技术分析患者CYP2C19基因多态性,并分析其抗血小板治疗及预后情况。结果在189例患者中,氯吡格雷快代谢型115例(60.85%)、中间代谢型67例(35.45%)、慢代谢型7例(3.70%),CYP2C19*2突变率为34.39%,CYP2C19*3突变率为4.76%。74例中间代谢型和慢代谢型患者中55例未调整治疗方案,再发心脑血管事件入院8例,占比14.55%;19例调整治疗方案,再发心脑血管事件入院2例,占比10.53%,两组间差异有统计学意义。结论CYP2C19基因多态性是影响氯吡格雷抗血小板治疗效果的重要因素之一,服用氯吡格雷前进行CYP2C19基因型检测具有重要意义。

Objective To explore the effects of CYP2C19 gene polymorphism on individualized therapy of clopidogrel in minority patients.Methods A total of 189 minority patients with cardiovascular and cerebrovascular diseases in our hospital were selected.CYP2C19 gene polymorphism was analyzed by fluorescence immunohybridization method,and its antiplatelet therapy and prognosis were analyzed.Result Among 189 patients,115 patients(60.85%)were clopidogrel fast metabolic type,67 patients(35.45%)were clopidogrel intermediate metabolic type,and 7 patients(3.70%)were clopidogrel slow metabolic type.CYP2C19*2 mutation rate was34.39%,and CYP2C19*3 mutation rate was 4.76%.Among 74 patients with intermediate metabolic type and slow metabolic type,there were 55 patients did not adjust the treatment plan,and 8 patients were hospitalized with recurrent cardiovascular and cerebrovascular events,accounting for 14.55%.There were 19 patients adjusted the treatment plan,and 2 patients were hospitalized because their cardio-cerebrovascular diseases recurred,which accounted for 10.53%,and the difference between two groups was statistically significant.Conclusion CYP2C19 gene polymorphism is one of the important factors affecting clopidogrel antiplatelet therapy,it is important to detect CYP2C19 genotype before taking clopidogrel.