基因多态性检测在高危缺血性脑卒中患者抗血小板药物二级预防中的指导价值

Guidance value of gene polymorphism detection in the secondary prevention of antiplatelet drugs for patients with high-risk ischemic stroke

目的观察基因多态性检测在高危缺血性脑卒中患者抗血小板药物二级预防中的指导价值。方法选取2017年10月—2018年10月于福州市第二医院住院的高危缺血性脑卒中患者200例,采用随机数字表法分为对照组和试验组,各100例。对照组根据指南推荐选用抗血小板药物治疗,试验组根据基因检测分析结果及指南推荐选择抗血小板药物治疗。比较2组随访3、6、12个月终点事件发生率,存活时间,随访12个月累积生存率。结果试验组随访3、6、12个月终点事件发生率均低于对照组(P<0.01)。试验组平均存活时间长于对照组(P<0.01)。生存曲线结果显示,试验组12个月累积生存率高于对照组(χ^(2)=7.650,P<0.01)。结论通过基因多态性检测选用抗血小板药物治疗高危缺血性脑卒中患者能明显降低其12个月内终点事件发生率,提高患者累积生存率,该检测有利于指导临床医师个体化精准用药。

Objective To investigate the guidance value of gene polymorphism detection in the secondary prevention of antiplatelet drugs for patients with high-risk ischemic stroke.Methods In this study,patients with high-risk ischemic stroke who were hospitalized in Fuzhou Second Hospital from October 2017 to October 2018,and they were divided into the control group and the experimental group,100 cases in each group.The control group used antiplatelet drugs according to the guidelines,and the experimental group used antiplatelet drugs according to the results of genetic testing analysis and guidelines.Incidence of endpoint events followed-up for 3,6 and 12 months,survival time and cumulative survival rate within 12 months were compared between the two groups.Results Incidence of endpoint events followed-up for 3,6 and 12 months of the experimental group were lower than those of the control group(P<0.01).Average survival time in the experimental group was longer than that in the control group(P<0.01).Survival curve analysis results showed that,cumulative survival rate within 12 months of the experimental group was higher than that of the control group(χ^(2)=7.650,P=0.01).Conclusion Selecting antiplatelet drugs to treat patients with high-risk ischemic stroke through gene polymorphism detection can significantly reduce the incidence of endpoint events within 12 months and improve the cumulative survival rate of patients,so this detection is conducive to guiding clinicians to use drugs individually and accurately.