| 余东彪,马礼坤,余晓凡,等.CYP2C19基因多态性在冠心病经皮冠状动脉介入术后一年的随访研究[J].中国临床保健杂志,2019,22(6):766-769. |
| CYP2C19基因多态性在冠心病经皮冠状动脉介入术后一年的随访研究 |
| CYP2C19 gene polymorphism was followed up for one year after PCI |
| 投稿时间：2018-08-20 |
| DOI：10.3969/J.issn.1672-6790.2019.06.012 |
| 中文关键词: 冠心病 氯吡格雷 替格瑞洛 细胞色素P-450酶系统 经皮冠状动脉介入治疗 血小板聚集抑制剂 预后 |
| 英文关键词: Coronary disease Clopidogrel Ticagrelor Cytochrome P-450 enzyme system Percutaneous coronary intervention Platelet aggregation inhibitors Prognosis 〖FL |
| 基金项目:安徽省科技攻关计划项目(1604a0802074) |
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| 中文摘要: |
| 目的 观察替格瑞洛和氯吡格雷的临床疗效,并探讨其与CYP2C19基因多态性的关系。 方法 入选2016年4月至2017年5月在中国科技大学附属第一医院接受住院治疗并行经皮冠状动脉介入术(PCI)的急性冠脉综合征患者492例,所有患者均接受CYP2C19基因型检测,根据患者口服抗血小板聚集药物分为氯吡格雷组和替格瑞洛组。随访1年,观察两组患者主要心脏不良事件(MACE)和出血并发症的发生率。根据CYP2C19基因检测将两组分别分为三个亚组:快代谢型(CYP2C19*1/*1)、中代谢型(CYP2C19*1/*2、CYP2C19*1/*3)和慢代谢型(CYP2C19*2/2*、CYP2C19*2/3*、CYP2C19*3/3*),分别观察各亚组患者的MACE发生率和治疗期间出血并发症的发生情况。 结果 替格瑞洛组和氯吡格雷组一年的死亡率、心肌梗死、心绞痛、脑梗死差异均无统计学意义,大中等量出血并无增加,小出血替格瑞洛组较氯吡格雷组有增加趋势,但差异无统计学意义。亚组分析中,替格瑞洛组与氯吡格雷组中的CYP2C19慢、中、快代谢相比,各亚组中一年的死亡率、心肌梗死、心绞痛、脑梗死差异均无统计学意义,大中等量出血并无增加,小出血替格瑞洛组较氯吡格雷组有增加趋势,但差异无统计学意义。 结论 替格瑞洛和氯吡格雷抗血小板聚集疗效及预后不受CYP2C19基因多态性的影响。 |
| 英文摘要: |
| Objective To observe the clinical efficacy of tigrarillo and clopidogrel and explore their relationship with CYP2C19 polymorphisms. Methods 492 patients with acute coronary syndrome who received inpatient treatment and PCI surgery were enrolled.All patients were tested for CYP2C19 genotype.Patients were followed up for one year to observe the incidence of major cardiac adverse events (MACE) and hemorrhagic complications in both groups.According to the CYP2C19 gene detection,the two groups were divided into three subgroups:fast metabolism type (CYP2C19*1/*1),medium metabolism type (CYP2C19*1/*2),and slow metabolism type (CYP2C19*2/2*,CYP2C19*2/3*,and CYP2C19*3/3*).The incidence of MACE and the occurrence of bleeding complications were observed in each subgroup. Results The one-year mortality rate,myocardial infarction,angina pectoris,and cerebral infarction were not statistically significant in the tigreolo group and the clopidogrel group.Subgroup analysis,for Greg CYP2C19 in los group respectively with fast,medium and slow metabolism in the clopidogrel group CYP2C19 fast,medium and slow metabolism,compared to the one year of various subgroups of mortality,myocardial infarction,angina pectoris,cerebral infarction had no statistical significance,and amount of bleeding is not increased,little bleeding for Greg increase trend in the clopidogrel group,but no statistical significance. Conclusion The efficacy and prognosis of antiplatelet aggregation by tigrerot and clopidogrel are not affected by CYP2C19 polymorphisms. |
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