河北张家口地区急性脑梗死患者CYP2C19基因多态性分析

Analysis of CYP2C19 Gene Polymorphism in Ischemic Stroke Patients in Zhangjiakou Area,Hebei

目的:分析河北张家口地区急性脑梗死患者氯吡格雷相关基因CYP2C19多态性的分布及频率情况。方法:选取2021年9月至2023年3月河北北方学院附属第一医院收治住院的急性脑梗死病人249例,采集口腔黏膜脱落细胞,采用POCT法检测CYP2C19基因分型,按照性别、年龄分组,比较各组之间CYP2C19基因型及氯吡格雷代谢类型的分布。结果:检测得到5种基因型:快代谢型CYP2C19*1/*1,共96例,占38.60%;中代谢型中CYP2C19*1/*2,共112例,占45.00%,CYP2C19*1/*3,共10例,占4.00%;慢代谢型中CYP2C19*2/*2,共25例,占10.00%,CYP2C19*2/*3,共6例,占2.40%。等位基因*1、*2、*3的频率分布分别为63.05%、63.05%、3.21%。本研究未检出CYP2C19*1/*17、CYP2C19*17/*17、CYP2C19*2/*17、CYP2C19*3/*17、CYP2C19*3/*3基因型。性别与基因型及代谢型分布频率差异无统计学意义(P>0.05)。年龄与基因型及代谢型分布频率差异无统计学意义(P>0.05)。结论:河北张家口地区急性缺血性脑卒中(acute ischemic stroke,AIS)患者氯吡格雷相关基因CYP2C19多态性主要以中代谢型为主,中慢代谢型共占61.40%,多数人有血小板高反应性,故用药前因进行基因检测,制定安全、合理、有效、经济的个性化药物治疗方案。

Objective:To analyze the distribution and frequency of clopidogrel related gene CYP2C19 polymorphism in patients with acute cerebral infarction in Zhangjiakou area of Hebei province.Methods:249 patients with acute cerebral infarction admitted to the first affiliated Hospital of Hebei North University from September 2021 to March 2023 were selected.The exfoliated cells of oral mucosa were collected and CYP2C19 genotyping was detected by POCT method.The patients were divided into groups according to sex and age,and the distribution of CYP2C19 genotypes and clopidogrel metabolic types among the groups were compared.Results:Five genotypes were detected:fast metabolic CYP2C19*1/*1 in 96 cases,accounting for 38.60%;CYP2C19*1/*2 in middle metabolic type,accounting for 45.00%,10 cases,accounting for 4.00%;slow metabolic type,25 cases,accounting for 10.00%,CYP2C19*2/*3,6 cases,accounting for 2.40%.The frequency distributions of alleles*1,*2 and*3 were 63.05%,63.05%and 3.21%,respectively.No genotypes of CYP2C19*1/*17,CYP2C19*17/*17,CYP2C19*2/*17,CYP2C19*3/*17 and CYP2C19*3/*3 were detected in this study.There was no significant difference in sex,genotype and metabolic type distribution frequency(P>0.05).There was no significant difference in age,genotype and metabolic type distribution frequency(P>0.05).Conclusion:The CYP2C19 polymorphism of clopidogrel related gene in patients with acute AIS in Zhangjiakou area of Hebei Province is mainly middle metabolic type,and the middle and slow metabolic type accounts for 61.40%.Most people have platelet hyperresponsiveness,so gene detection is carried out before medication to develop a safe,reasonable,effective and economical personalized drug treatment plan.