河南省心脑血管疾病患者CYP2C19基因多态性分析

CYP2C19 Gene Polymorphism in Patients with Cardio-Cerebrovascular Diseases in Henan Province

目的研究河南省心脑血管疾病患者CYP2C19基因多态性,为氯吡格雷个体化用药提供参考。方法以河南省1182例心脑血管疾病患者为研究对象,利用单碱基延伸法检测CYP2C19基因型,比较不同性别、年龄患者CYP2C19代谢表型分布,结合既往文献比较河南省与其他几个省份患者CYP2C19代谢表型分布。结果共检出10种基因型,分别为*17/*17、*1/*17、*1/*1、*1/*2、*1/*3、*2/*17、*3/*17、*2/*2、*2/*3、*3/*3,其中*1/*1基因型出现频率最高(40.69%),国内很少出现的*17/*17基因型在本研究中检出1例(0.08%)。10种基因型共可分为4种代谢表型,即超快代谢型(1.95%)、快代谢型(40.69%)、中间代谢型(43.74%)和慢代谢型(13.62%)。不同性别和不同年龄的患者CYP2C19代谢表型分布差异无统计学意义(P>0.05)。河南省CYP2C19代谢表型分布与重庆、福建省和湖北省CYP2C19代谢表型分布情况相比,差异有统计学意义(P<0.05)。结论河南省心脑血管疾病患者CYP2C19基因多态性具有一定的地域特点,超过50%的患者为中间代谢型和慢代谢型。因此,建议对服用或拟服用氯吡格雷的患者进行CYP2C19基因检测,根据检测结果制定用药方案,及时调整氯吡格雷剂量或更换药物,以减少心脑血管不良事件的发生。

Objective To study the CYP2C19 gene polymorphism in patients with cardio-cerebrovascular diseases in Henan Province,and to provide references for personalized clopidogrel medication.Methods A total of 1182 patients with cardio-cerebrovascular diseases in Henan Province were included as the research objects.The CYP2C19 genotype was detected by the single base extension technology.The CYP2C19 metabolic phenotype distribution of patients of different genders and ages was compared.The CYP2C19 metabolic phenotype distribution of patients in Henan province and several other provinces was compared combined with previous literature.Results A total of 10 genotypes were detected,namely*17/*17,*1/*17,*1/*1,*1/*2,*1/*3,*2/*17,*3/*17,*2/*2,*2/*3,*3/*3.Among them,the*1/*1 genotype appeared most frequently(40.69%).The*17/*17 genotype that rarely appeared in China appeared in 1 case(0.08%).The 10 genotypes could be divided into 4 metabolic phenotypes.The proportions of CYP2C19 metabolic phenotypes for ultrafast,extensive,intermediate and poor metabolizers were 1.95%,40.69%,43.74%and 13.62%,respectively.There was no statistical difference in the distribution of CYP2C19 metabolic phenotype between patients of different genders and different ages(P>0.05).The distribution of CYP2C19 metabolic phenotype in Henan province was statistically different from that of Chongqing,Fujian province and Hubei province(P<0.05).Conclusion The CYP2C19 gene polymorphism in patients with cardio-cerebrovascular diseases in Henan Province has certain regional characteristics,and more than 50%of patients are of intermediate or slow metabolites.Therefore,it is recommended to perform CYP2C19 gene testing for patients taking or planning to take clopidogrel,formulate a medication plan based on the test results,and adjust the clopidogrel dose or change the drug in time to reduce the occurrence of cardiovascular and cerebrovascular adverse events.