Individual variation in the response to drug therapy has been mainly attributed to the genetic polymorphism of cytochrome P 450 isoenzymes. Mutation in the gene CYP2C19 （cytochrome P450 2C19） has been shown to influ...Individual variation in the response to drug therapy has been mainly attributed to the genetic polymorphism of cytochrome P 450 isoenzymes. Mutation in the gene CYP2C19 （cytochrome P450 2C19） has been shown to influence the clinical efficiency of clopidogrel. The aim is to investigate the frequencies of CYP2C19＊2 （c.G681A; rs4244285）, CYP2C19＊3 （c.G636A; rs4986893）, CYP2C19＊17 （c.C806T; rs12248560） and to compare the allele and genotype frequencies of CYP2C19＊2 in patients with CHD （coronary heart disease） to healthy volunteers. We examined 53 patients with CHD received clopidogrel and 146 healthy volunteers. CYP2C19＊2, CYP2C19＊3, CYP2C19＊17 carriages were determined by a polymerase-chain reaction. The observed genotype distribution did not deviate from Hardy-Weinberg equilibrium, it was determined by a Chi-square test with Yates correction. The frequency of CYP2C19＂2 allele reported in patients with CHD and in the healthy volunteers was 16.6% and 13.3%, respectively （P = 0.584）. The results of the present study may be helpful in developing current and future directions for its management.展开更多
We investigated the variability in the PFT （platelet function test） response to CYP2C19 polymorphisms and compared it with the clinical presentation. Furthermore, running cost analyses were done. One-hundred and sev...We investigated the variability in the PFT （platelet function test） response to CYP2C19 polymorphisms and compared it with the clinical presentation. Furthermore, running cost analyses were done. One-hundred and seventy Saudi Arabian patients who were stable on 75 mg clopidogrel for ≥1 month for various cardiac indications were enrolled. We extracted DNA using the MagNA Pure LC instrument. CYP2C19 genotyping for the alleles, ＊1, ＊2 and ＊3, was conducted by real-time PCR （polymerase chain reaction）. The PFT was carried out by VerifyNow P2Y12 assay for all patients. Clinical events were documented retrospectively for all patients. One hundred and seventeen patients presented with the wild variant 1/1, 19 patients with 1/2, and 34 patients with 2/2. We could not detect ＊3. There was a significant association between different genotyping and percentage inhibitions （P = 0.0002）. 1/1 patients tended to be moderate-to-extensive metabolisers, whereas most of the other patients were slow metabolisers. The cost of doing the PFT was 250 SR （Saudi Riyals）/patient and 200 SR/patient for kits and materials （excluding equipment and labour）. The PFT varied considerably with polymorphisms, but showed no significant associations with clinical symptoms.展开更多
目的探讨黑龙江地区脑梗死患者接受氯吡格雷治疗时CYP2C19基因多态性对治疗效果的影响。方法选取2022年1—12月在黑龙江省医院神经内科住院的90例脑梗死患者为研究对象。检测CYP2C19基因多态性,根据检测结果,将患者分为3组,快代谢组(n=...目的探讨黑龙江地区脑梗死患者接受氯吡格雷治疗时CYP2C19基因多态性对治疗效果的影响。方法选取2022年1—12月在黑龙江省医院神经内科住院的90例脑梗死患者为研究对象。检测CYP2C19基因多态性,根据检测结果,将患者分为3组,快代谢组(n=26)、中等代谢组(n=52)和慢代谢组(n=12)。所有患者均给予氯吡格雷治疗,对美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分及预后情况进行观察对比。结果在脑梗死患者中以快代谢型和中等代谢型为主要类型。治疗2周后,3组NIHSS评分低于治疗前,差异有统计学意义(P<0.05);且快代谢组评分为(6.23±1.38)分,低于中等代谢组、慢代谢组的(7.76±1.71)分、(10.12±1.29)分,差异有统计学意义(P<0.05);快代谢组和中等代谢组预后良好率高于慢代谢组(P<0.05);快代谢组、中等代谢组和慢代谢组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论通过对老年脑梗死患者行CYP2C19基因型检测来评估对氯吡格雷治疗的药物代谢能力和反应情况。有助于制定个体化的治疗方案,提高治疗效果并降低不良反应的发生率,可以最大限度地提高治疗效果,减少风险发生。展开更多
目的:探讨急性期基因背景不明的轻型非心源性脑梗死患者行替格瑞洛或氯吡格雷抗血小板治疗的价值,为临床更高效、精准治疗提供参考。方法:选取新疆生产建设兵团第六师医院2022年1月至2023年6月收治的150例基因不明的急性轻型非心源性脑...目的:探讨急性期基因背景不明的轻型非心源性脑梗死患者行替格瑞洛或氯吡格雷抗血小板治疗的价值,为临床更高效、精准治疗提供参考。方法:选取新疆生产建设兵团第六师医院2022年1月至2023年6月收治的150例基因不明的急性轻型非心源性脑梗死患者为研究对象,充分向患者及(或)其家属说明各治疗方案下,采用随机数字表法分为A组、B组与C组,观察与比较每组患者美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数量表(Barthel index,BI)评分变化情况,并统计患者不良反应发生情况与复发率。结果:三组治疗21d、90d后的NIHSS、BI评分对比差异无统计学意义(P>0.05)。治疗90d后随访,三组出血发生率、消化道不良反应发生率对比差异无统计学意义(P>0.05);A组、C组脑梗死复发率(2.00%、4.00%)相当(P>0.05),但均低于B组(P<0.05)。结论:替格瑞洛联合阿司匹林双抗方案可绕行CYP2C19基因缺陷,在治疗急性轻型非心源性脑梗死中,与传统氯吡格雷双抗对改善患者神经与日常生活功能效果相当,但能更有效地预防90d内脑梗死复发,在基因背景不明下,疗效更具优势。展开更多
文摘Individual variation in the response to drug therapy has been mainly attributed to the genetic polymorphism of cytochrome P 450 isoenzymes. Mutation in the gene CYP2C19 （cytochrome P450 2C19） has been shown to influence the clinical efficiency of clopidogrel. The aim is to investigate the frequencies of CYP2C19＊2 （c.G681A; rs4244285）, CYP2C19＊3 （c.G636A; rs4986893）, CYP2C19＊17 （c.C806T; rs12248560） and to compare the allele and genotype frequencies of CYP2C19＊2 in patients with CHD （coronary heart disease） to healthy volunteers. We examined 53 patients with CHD received clopidogrel and 146 healthy volunteers. CYP2C19＊2, CYP2C19＊3, CYP2C19＊17 carriages were determined by a polymerase-chain reaction. The observed genotype distribution did not deviate from Hardy-Weinberg equilibrium, it was determined by a Chi-square test with Yates correction. The frequency of CYP2C19＂2 allele reported in patients with CHD and in the healthy volunteers was 16.6% and 13.3%, respectively （P = 0.584）. The results of the present study may be helpful in developing current and future directions for its management.
文摘We investigated the variability in the PFT （platelet function test） response to CYP2C19 polymorphisms and compared it with the clinical presentation. Furthermore, running cost analyses were done. One-hundred and seventy Saudi Arabian patients who were stable on 75 mg clopidogrel for ≥1 month for various cardiac indications were enrolled. We extracted DNA using the MagNA Pure LC instrument. CYP2C19 genotyping for the alleles, ＊1, ＊2 and ＊3, was conducted by real-time PCR （polymerase chain reaction）. The PFT was carried out by VerifyNow P2Y12 assay for all patients. Clinical events were documented retrospectively for all patients. One hundred and seventeen patients presented with the wild variant 1/1, 19 patients with 1/2, and 34 patients with 2/2. We could not detect ＊3. There was a significant association between different genotyping and percentage inhibitions （P = 0.0002）. 1/1 patients tended to be moderate-to-extensive metabolisers, whereas most of the other patients were slow metabolisers. The cost of doing the PFT was 250 SR （Saudi Riyals）/patient and 200 SR/patient for kits and materials （excluding equipment and labour）. The PFT varied considerably with polymorphisms, but showed no significant associations with clinical symptoms.
文摘目的探讨黑龙江地区脑梗死患者接受氯吡格雷治疗时CYP2C19基因多态性对治疗效果的影响。方法选取2022年1—12月在黑龙江省医院神经内科住院的90例脑梗死患者为研究对象。检测CYP2C19基因多态性,根据检测结果,将患者分为3组,快代谢组(n=26)、中等代谢组(n=52)和慢代谢组(n=12)。所有患者均给予氯吡格雷治疗,对美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分及预后情况进行观察对比。结果在脑梗死患者中以快代谢型和中等代谢型为主要类型。治疗2周后,3组NIHSS评分低于治疗前,差异有统计学意义(P<0.05);且快代谢组评分为(6.23±1.38)分,低于中等代谢组、慢代谢组的(7.76±1.71)分、(10.12±1.29)分,差异有统计学意义(P<0.05);快代谢组和中等代谢组预后良好率高于慢代谢组(P<0.05);快代谢组、中等代谢组和慢代谢组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论通过对老年脑梗死患者行CYP2C19基因型检测来评估对氯吡格雷治疗的药物代谢能力和反应情况。有助于制定个体化的治疗方案,提高治疗效果并降低不良反应的发生率,可以最大限度地提高治疗效果,减少风险发生。
文摘目的:探讨急性期基因背景不明的轻型非心源性脑梗死患者行替格瑞洛或氯吡格雷抗血小板治疗的价值,为临床更高效、精准治疗提供参考。方法:选取新疆生产建设兵团第六师医院2022年1月至2023年6月收治的150例基因不明的急性轻型非心源性脑梗死患者为研究对象,充分向患者及(或)其家属说明各治疗方案下,采用随机数字表法分为A组、B组与C组,观察与比较每组患者美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数量表(Barthel index,BI)评分变化情况,并统计患者不良反应发生情况与复发率。结果:三组治疗21d、90d后的NIHSS、BI评分对比差异无统计学意义(P>0.05)。治疗90d后随访,三组出血发生率、消化道不良反应发生率对比差异无统计学意义(P>0.05);A组、C组脑梗死复发率(2.00%、4.00%)相当(P>0.05),但均低于B组(P<0.05)。结论:替格瑞洛联合阿司匹林双抗方案可绕行CYP2C19基因缺陷,在治疗急性轻型非心源性脑梗死中,与传统氯吡格雷双抗对改善患者神经与日常生活功能效果相当,但能更有效地预防90d内脑梗死复发,在基因背景不明下,疗效更具优势。
