新疆地区缺血性脑卒中患者中氯吡格雷相关基因CYP2C19的基因多态性研究

Study on Polymorphism of Clopidogrel Related Gene CYP2C19 in Patients with Ischemic Stroke in Xinjiang

目的分析新疆地区缺血性脑卒中(IS)患者中氯吡格雷相关基因CYP2C19的基因多态性分布情况。方法收集新疆维吾尔自治区人民医院神经内科因IS接受治疗的227例患者的全血标本,检测CYP2C19基因的不同基因型。按年龄、性别、民族等因素进行分组,比较汉族与维吾尔族人群间CYP2C19基因型和氯吡格雷代谢类型的分布。结果不同民族间的IS高危因素比较,差异无统计学意义(P>0.05),维吾尔族IS患者AA基因型频率低于汉族患者,但差异无统计学意义(P>0.05)。维吾尔族患者CYP2C19*17基因多态性CT基因型频率显著高于汉族患者,差异有显著统计学意义(P<0.001)。维吾尔族与汉族间的代谢类型分布比较:超快代谢型仅在维吾尔族患者中存在,快代谢型维吾尔族病例数较汉族多(P<0.001)。结论新疆地区IS患者氯吡格雷相关基因CYP2C19的基因多态性在汉族与维吾尔族人群间存在差异;超快代谢类型仅在维吾尔族中出现,快代谢和超快代谢类型维吾尔族IS患者显著多于汉族患者。

Aim To analyze the distribution of clopidogrel-related gene CYP2C19 polymorphism in patients with ischemic stroke(IS)in Xinjiang.Methods The whole blood samples of 227 patients with ischemic stroke(IS)in the department of neurology,the People’s Hospital of Xinjiang Uygur Autonomous Region were collected.Different CYP2C19 genotypes were detected and divided into different groups according to age,sex,nationality and other factors.The distribution of CYP2C19genotypes and clopidogrel metabolic types between Han nationality and Uygur nationality were compared.Results There was no significant difference in the risk factors of ischemic stroke among the different ethnic groups.The frequency of AA genotype in Uygur patients was significantly lower than that in Han patients,but the difference was not significant.The frequency of CT genotype of CYP2C1917 gene polymorphism in Uygur patients was significantly higher than that in Han patients(P<0.001).At the same time,the distribution of metabolic types in different ethnic groups showed that ultrafast metabolic types only existed in Uygur patients,and the number of fast metabolic types was much higher than that in Han patients(P<0.001).Conclusion There is a difference in clopidogrel-related gene polymorphism between Han nationality and Uygur nationality in Xinjiang.In Uygur patients,ultrafast metabolism only appeared in Uygur patients and in metabolic types,fast metabolism and ultrafast metabolism were significantly higher than those in Han patients.