CYP2C19基因多态性与急性冠状动脉综合征患者氯吡格雷抵抗的相关性分析

The analysis on the correlation between CYP2C19 gene polymorphism and clopidogrel resistance in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者CYP2C19多态性与氯吡格雷抵抗(CR)的关系。方法选择2019年6月至2020年6月赤峰学院附属医院收治的行经皮冠状动脉介入疗法(PCI)的ACS患者127例,其中具有CR的患者29例(CR组),非氯吡格雷抵抗(NCR)患者98例(非NCR组)。比较两组患者的临床资料、冠状动脉造影结果,并分析CYP2C19*2和CYP2C19*3多态性与CR的关系。结果两组患者一般资料及冠状动脉造影结果比较差异无统计学意义(P>0.05)。两组患者CYP2C19(rs4244285)和CYP2C19(rs4986893)上等位基因及基因型分布存在差异(P<0.05)。Logistic回归分析结果显示,CYP2C19*2和CYP2C19*3的多态性是CR的危险因素(OR=14.688,95%CI 3.652~59.063,P<0.01;OR=7.228,95%CI 2.412~21.663,P<0.01)。结论CR与ACS患者CYP2C19*2和CYP2C19*3密切相关。

Objective To analyze the relationship between CYP2C19 polymorphism and clopidogrel resistance(CR)in patients with acute coronary syndrome(ACS).Methods One hundred and twenty-seven ACS patients treated with percutaneous coronary intervention(PCI)from June 2019 to June 2020 were enrolled,including 29 patients with CR(CR group)and 98 patients with none clopidogrel resistance(NCR,NCR group).The clinical data,coronary angiography results were compared between the two groups,the relationship of CYP2C19*2 and CYP2C19*3 polymorphisms and CR were analyzed.Results The general data and coronary angiography between two groups had no significant differences(P>0.05).There were differences in the distribution of isogenic genes and genotypes of CYP2C19(rs4244285)and CYP2C19(rs4986893)between the two groups(P<0.05).Polymorphism of CYP2C19*2 and CYP2C19*3 was an important risk factor for CR(OR=14.688,95%CI 3.652-59.063,P<0.01;OR=7.228,95%CI 2.412-21.663,P<0.01).Conclusions CR is closely associated with CYP2C19*2 and CYP2C19*3 in ACS patients.