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重庆永川区冠心病患者CYP2C19基因型分布研究

Distribution of CYP2C19 genotypes in patients with coronary heart disease in Yongchuan District,Chongqing
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摘要 目的研究重庆永川区冠心病患者CYP2C19基因型分布情况。方法选取永川区人民医院2020年4月至2021年2月明确诊断为冠心病,并服用氯吡格雷的患者371例,抽取其静脉血进行CYP2C19基因检测,分析等位基因,基因型,代谢型分布情况,并与中国不同地区汉族冠心病患者的代谢型分布频率进行比较。结果在371例患者中,CYP2C19基因总共检出7种基因型:*1/*17(1.08%)、*1/*1(40.16%)、*1/*2(38.27%)、*1/*3(5.39%)、*2/*2(11.59%)、*3/*3(0.27%)、*2/*3(3.23%),未发现*17/*17、*2/*17和*3/*17基因型;超快代谢型,快代谢型,中间代谢型和慢代谢型患者数量分别为4(1.08%),149(40.16%),162(43.67%),56(15.09%);植入支架数量、年龄、性别的代谢型发生频率差异均无统计学意义(P>0.05);永川区CYP2C19基因各代谢型分布与中国西南、西北、东北及南方冠心病患者相比无统计学差异(P>0.05)。结论重庆永川区冠心病患者CYP2C19基因主要以中间代谢型和慢代谢型总占比较多,发生氯吡格雷抵抗风险更高,建议该地区冠心病患者在氯吡格雷治疗前进行CYP2C19基因筛查,对于氯吡格雷个体化用药和减少心血管事件的发生具有重要意义。 Objective To explor the distribution of CYP2C19 genotypes in patients with coronary heart disease in Yongchuan District,Chongqing.Methods Totally 371 patients with coronary heart disease(CHD) who were treated with clopidogrel and received medical care in Yongchuan People's Hospital from April 2020 to February 2021 were enrolled as study subjects,Their venous blood were for CYP2C19 gene detected,and the allele,genotype,and phenotype of CYP2C19 were analyzed,The results were compared with other cities of China.Results Seven genotypes of CYP2C19 gene were tested in 371 patients:*1/*17(1.08%),*1/*1(40.16%),*1/*2(38.27%),*1/*3(5.39%),*2/*2(11.59%),*3/*3(0.27%),*2/*3(3.23%),but *17/*17、*2/*17 and *3/*17 were not detected.The phenotypes of patients with ultrarapid metabolizer,extensive metabolizer,intermediate metabolizer,and poor metabolizer were 4(1.08%),149(40.16%),162(43.67%),and 56(15.09%),respectively.There was no statistically significant difference in the frequency of metabolic phenotypes of different stent numbers,ages,and genders(P>0.05).The distribution of CYP2C19 gene metabolotypes in Yongchuan was not statistically different from that of patients with CHD in southwest,northwest,northeast and south China(P>0.05).Conclusions The CYP2C19 gene in patients with CHD in Yongchuan District of Chongqing is mainly composed of intermediate metabolizers and slow metabolizers,and the risk of clopidogrel resistance is higher.It is recommended that patients with CHD in Yongchuan District,Chongqing,should take CYP2C19 test before clopidogrel treatment,which is of great significance for the individualized medication of clopidogrel and the reduction of the occurrence of cardiovascular events.
作者 徐筑君 石春林 XU Zhu-jun;SHI Chun-lin(Yongchuan People's Hospital of Chongqing,Chongqing 402160,China)
出处 《医药论坛杂志》 2023年第12期58-62,共5页 Journal of Medical Forum
关键词 冠心病 氯吡格雷 CYP2C19 基因型 代谢型 Coronary Heart Disease clopidogrel CYP2C19 Genotype Phenotype
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