| 以CYP2C19基因多态性指导经皮冠状动脉介入治疗术后抗凝临床疗效观察 |
| |
| 引用本文： | 周建华,刘科兰,吴干斌. 以CYP2C19基因多态性指导经皮冠状动脉介入治疗术后抗凝临床疗效观察[J]. 金属学报, 2018, 23(12): 1364-1367. DOI: 10.12092/j.issn.1009-2501.2018.12.008 |
| |
| 作者姓名： | 周建华 刘科兰 吴干斌 |
| |
| 作者单位： | 郑州大学第二附属医院药学部，郑州 450014，河南 |
| |
| 基金项目： | 河南省教育厅科学技术研究重点项目（14A350014） |
| |
| 摘 要： | 目的: 对进行经皮冠状动脉介入治疗术（PCI）的患者体内CYP2C19的基因多态性进行分析，并根据基因分型对术后患者进行不同的抗凝治疗，以观察临床疗效。方法: 采用聚合酶链反应-限制性片段长度多态性检测技术对进行PCI手术患者体内CYP2C19的基因型进行分析并分组，分为快、中、慢三种代谢型组，快代谢型组和中间代谢型组在术前24 h内给予负荷剂量氯吡格雷300 mg，之后分别服用氯吡格雷75 mg/d和150 mg/d；对于慢代谢型组起始单次负荷剂量替格瑞洛180 mg，维持量90 mg,bid；上述三组患者术后均联合服用阿司匹林100 mg/d，均连用12个月；观察术后一年内患者主要不良心血管事件的发生率。结果: 178例患者中共检测出5种CYP2C19的基因分型，分别为*1/*1型、*1/*2型、*1/*3型、*2/*2型和*2/*3型；其中快代谢型（*1/*1型）67例，占37.6%，中间代谢型（*1/*2型和*1/*3型）99例，占55.6%，慢代谢型（*2/*2型和*2/*3）12例，占6.8%；术后一年主要不良心血管事件的发生率在三组之间相近（P>0.05)。 结论: CYP2C19基因分型可以用于PCI术后患者的用药指导，对于快代谢型的患者可以给予常规剂量的氯吡格雷，对于发生突变的患者可以考虑增加氯吡格雷的剂量或更换其他抗凝药物。
|
| 关 键 词： | CYP2C19 基因多态性 PCI 个体化用药 |
| 收稿时间： | 2018-08-30 |
| 修稿时间： | 2018-10-28 |
Effects of anti-platelet individual treatment guided by CYP2C19 polymorphism |
| |
| ZHOU Jianhua,LIU Kelan,WU Ganbin. Effects of anti-platelet individual treatment guided by CYP2C19 polymorphism[J]. Acta Metallurgica Sinica, 2018, 23(12): 1364-1367. DOI: 10.12092/j.issn.1009-2501.2018.12.008 |
| |
| Authors: | ZHOU Jianhua LIU Kelan WU Ganbin |
| |
| Affiliation: | The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan, China |
| |
| Abstract: | AIM: To investigate the genetic polymorphism of CYP2C19 among patients requiring percutaneous coronary intervention（PCI）, and to determine the anticoagulation therapy according to genotypes so as to observe its clinical efficacy. METHODS: CYP2C19 variants were detected by PCR-RFLP method in patients requiring PCI. The extensive metabolism（EM）group was treated with clopidogrel with loading dose of 300 mg at the first time and 75 mg/d for 12 months.While the intermediate metabolism (IM) group was treated with clopidogrel with loading dose of 300 mg at the first time and 150 mg/d for 12 months.The poor metabolism (PM) group was treated with ticagrelor with loading dose of 180 mg at the first time and 90 mg,bid for 12 months.All three groups were given Aspirin of 100 mg/d. During the follow-up of 12 months,the incidence rates of major adverse cardiac events （MACE） in the three groups were observed and compared. RESULTS: Five genotypes of CYP2C19 were found in these subjects,and that the frequency of EM was 37.6%,IM 55.6% and PM 6.8%.No significant difference related to the incidence rates of major adverse cardiac events in the three groups during the follow-up of 12 months was observed. CONCLUSION: CYP2C19 genotype can instruct the medication of anticoagulation therapy; patients with fast metabolism can receive regular dose of clopidogrel, while patients with mutation should consider larger dose of clopidogrel or other anticoagulation drugs. |
| |
| Keywords: | CYP2C19 genotype polymorphism PCI individualized therapy |
|
| 点击此处可从《金属学报》浏览原始摘要信息 |
|
点击此处可从《金属学报》下载全文 |
