阿司匹林精准用药在免疫复发性流产治疗中的应用

Application of the precision medicine of aspirin for treating patients with immune recurrent spontaneous abortion

目的:探讨复发性流产患者阿司匹林基因检测用以指导临床精准用药。方法:收集本院2022年6月-2023年12月本院诊疗的复发性流产患者50例,均接受阿司匹林用药前血液基因检测,分析检测结果并调整用药方案。结果:50例复发性流产患者阿司匹林药物基因检测,阿司匹林抵抗基因CYP2C19和CHIA分别检测到3种基因分型GG、GA和AA,LTC4S检测到3种分型AC、CC和AA;药物疗效基因GP1BA检测到2种分型CC和CT,PTGS1检测到均是AA分型。根据检测结果对患者进行用药指导,50例患者中21例更换了治疗方案,3例继续用药并需密切监测药物不良反应。结论:对复发性流产患者进行阿司匹林药物基因组检测,可精准指导患者临床用药。

Objective:To exploration of the gene detection for the instructional aspirin precision medicine for patients with immune recurrent spontaneous abortion.Methods:50 patients with recurrent spontaneous abortion who had treated in hospital between June 2022 and December 2023 were collected in this study.The genetic testing based on blood samples of these patients were conducted before their aspirin administration,and the medication regimen of aspirin was adjusted according to the genetic testing results.Results:Genetic testing was performed on 50 patients with recurrent spontaneous abortion.Three genotypes GG,GA,and AA of the aspirin resistance genes CYP2C19 and CHIA were detected,and three genotypes AC,CC,and AA of gene LTC4S were detected.Two genotypes CC and CT of drug efficacy gene GP1BA were detected.All the genotypes detected of gene PTGS1 were AA.Based on the gene test results,the subsequent guidance of aspirin administration was provided to the patients.Among 50 patients with aspirin used,21 cases had changed their treatment regimens,and 3 cases had continual their treatment regimens but required close monitoring of their drug adverse reactions.Conclusion:Aspirin pharmacogenomic testing for the patients with recurrent miscarriage can precisely guide their clinical drug used.