KDR rs1870377基因与经皮冠状动脉介入治疗术后氯吡格雷耐药相关性分析

Analysis of the Correlation between KDR rs1870377 Gene and Clopidogrel Resistance after PCI

目的:探讨与分析KDR rs1870377基因与经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)术后氯吡格雷耐药相关性。方法:2018年5月到2021年2月选在航天中心医院(北京大学航天临床医学院)老年医学一科住院的冠心病患者97例作为研究对象,所有患者在PCI术后判定氯吡格雷耐药情况,检测KDR rs1870377基因多态性状况并进行相关性分析。结果:在97例患者中,PCI术后氯吡格雷耐药22例(耐药组),耐药率为22.7%。耐药组的空腹血糖、总胆固醇、甘油三酯等与非耐药组对比差异无统计学意义(P>0.05)。KDR rs1870377基因主要包括AA、CC、CA三种基因型,两组都与Hardy-Weinberg平衡定律相符合,研究对象具有群体代表性。耐药组的KDR rs1870377基因CC基因型高于非耐药组(P<0.05),耐药组的等位基因C频率高于非耐药组(P<0.05)。Spearsman分析显示KDR rs1870377基因CC基因型、等位基因C与氯吡格雷耐药存在相关性(P<0.05)。多元Logistic回归分析显示KDR rs1870377基因CC基因型、等位基因C为导致PCI术后氯吡格雷耐药的重要因素(P<0.05)。结论:冠心病患者PCI术后氯吡格雷比较常见,也伴随有KDR rs1870377基因多态性,KDR rs1870377基因CC基因型、等位基因C为导致PCI术后氯吡格雷耐药的重要因素。

Objective: To explore and analysis the correlation between KDR rs1870377 gene and clopidogrel resistance after percutaneous coronary intervention(PCI). Methods: From May 2018 to February 2021, 97 cases of patients with coronary heart disease who were hospitalized in the First Department of Geriatrics of Space Center Hospital(Peking University School of Aerospace Clinical Medicine) were selected as the research objects. All patients were determined to be resistant to clopidogrel after PCI, and the KDR rs1870377 gene polymorphism were detected and correlation analysis. Results: There were 22 cases were resistant to clopidogrel after PCI(resistance group), and the drug resistance rate were 22.7 %. There were no significant difference in gender, age, body mass index,systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, fasting blood glucose, etc. compared between the resistant group and the non-resistant group(P>0.05). The KDR rs1870377 gene were mainly included three genotypes: AA, CC, and CA.The two groups were in accordance with the Hardy-Weinberg equilibrium law, and the research objects were representative of the group.The CC genotype of the KDR rs1870377 gene in the resistant group were higher than that in the non-resistant group(P<0.05), and the frequency of allele C in the resistant group were higher than that in the non-resistant group(P<0.05). Spearsman analysis showed that the CC genotype and allele C of KDR rs1870377 gene were correlated with clopidogrel resistance(P<0.05). Multivariate logistic regression analysis showed that the CC genotype and allele C of KDR rs1870377 gene were important factors leaded to clopidogrel resistance after PCI(P<0.05). Conclusion: Clopidogrel are more common after PCI in patients with coronary heart disease, and are also accompanied by KDR rs1870377 gene polymorphism. KDR rs1870377 gene CC genotype and allele C are important factors leading to clopidogrel resistance after PCI.