| 刘岩,刘艳霞,曲颖,等.环氧化酶基因多态性与阿司匹林抵抗及心血管事件发生的相关性研究[J].中国临床保健杂志,2021,24(3):320-323. |
| 环氧化酶基因多态性与阿司匹林抵抗及心血管事件发生的相关性研究 |
| The correlation between COX gene polymorphism and aspirin resistance,cardiovascular events |
| 投稿时间：2021-01-10 |
| DOI：10.3969/J.issn.1672-6790.2021.03.007 |
| 中文关键词: 心血管疾病 环氧化酶 多态现象,遗传 阿司匹林 危险因素 |
| 英文关键词: Cardiovascular diseases Cyclooxygenase Polymorphism,genetic Aspirin Risk factors 〖FL |
| 基金项目:辽宁省自然科学基金指导计划项目(20180550534,2019_ZD_1042) |
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| 中文摘要: |
| 目的 探讨与血小板聚集相关的环氧化酶(COX)基因多态性与阿司匹林抵抗及心血管事件发生之间的相关性,为缺血性心血管疾病患者抗血小板的个体化治疗提供理论依据。方法 选取2018年1月至2019年12月在北部战区总医院就诊的缺血性心血管疾病患者,入选前持续每天服用阿司匹林100 mg,至少7 d。通过聚合酶链反应技术检测花生四烯酸(AA)诱导血小板聚集率,血小板聚集率≥20%为阿司匹林抵抗组(AR组),血小板聚集率＜20%为阿司匹林敏感组(AS组),同时检测两组患者2个凝血相关基因位点(COX-1的rs1330344位点、COX-2的rs20714位点)基因多态性,比较两组间2个基因型是否存在差异。随访观察1年,记录两组患者心血管事件发生情况。结果 入选340例,年龄(65.31±9.06)岁,AR组110例(32.4%),AS组230例(67.6%),两组无失访和退出患者。AR组COX-1的rs1330344基因位点,G等位基因携带比例高于AS组,差异有统计学意义(74.5%比58.3%,P＜0.05)；AR组COX-2的rs20714位点C等位基因携带比例与AS组差异无统计学意义(13.6%比8.3%,P＞0.05)。1年内AR组心血管事件发生率为35.5%(39例),AS组心血管事件发生率为20.4%(47例),AR组心血管事件发生率明显高于AS组(P＜0.05)。COX-1的rs1330344位点携带G等位基因患者心血管事件发生率高于AA型基因患者,差异有统计学意义(29.6%比17.7%,P＜0.05)；COX-2的rs20714位点携带C等位基因患者心血管事件发生率与GG型基因患者差异无统计学意义(29.4%比24.8%,P＞0.05)。结论 缺血性心血管疾病患者COX-1基因的rs1330344位点携带G等位基因出现阿司匹林抵抗的风险更高,应用阿司匹林后心血管事件发生率更高。COX-2基因rs20714位点携带C等位基因与阿司匹林抵抗及应用阿司匹林后心血管事件复发率未见明显相关性。 |
| 英文摘要: |
| Objective To explore the correlation between COX gene polymorphism and aspirin resistance,cardiovascular events,to provide theoretical basis for individualized antiplatelet therapy in patients with ischemic cardiovascular disease.Methods Patients with ischemic cardiovascular diseases admitted to our hospital from January 2018 to December 2019 were selected to continue taking aspirin 100 mg daily for at least 7 days before enrollment.The platelet aggregation rate induced by arachidonic acid (AA) was monitored by PCR technique.Patients with AA induced platelet aggregation rate ≥20% were enrolled in aspirin resistance group (group A),and those with AA induced platelet aggregation rate＜20% were enrolled in aspirin sensitive group (group B).The coagulation related gene loci in the two groups (COX-1 gene rs1330344,COX-2 gen rs20714) were detected.The polymorphisms of COX genes in the two groups were compared.Follow-up observation was conducted for 1 year,and the incidence of cardiovascular events in both groups was recorded.Results A total of 340 patients were enrolled,the average age was (65.31±9.06)years.There were 110 patients (32.4%) in the AR group and 230 patients (67.6%) in the AS group.There was no loss of follow-up and withdrawal in the two groups.The proportion of G allele in rs1330344 locus of COX-1 in AR group was higher than that in AS group,and the difference was statistically significant (74.5% vs.58.3%,P＜0.05);the proportion of C allele at rs20714 locus of COX-2 in AR group was higher than that in AS group,but the difference was not statistically significant (13.6% vs.8.3%,P＞0.05).Within 1 year,the incidence of cardiovascular events in AR group was 35.5% (39 cases),and that in AS group was 20.4% (47 cases).The incidence of cardiovascular events in AR group was significantly higher than that in AS group (P＜0.05).According to COX genotype statistics,the incidence of cardiovascular events in patients with G allele of COX-1 gene rs1330344 locus was higher than that in patients with AA genotype,the difference was statistically significant (29.6% vs.17.7%,P＜0.05);the incidence of cardiovascular events in patients with C allele of COX-2 gene rs20714 locus was higher than that in patients with GG genotype,but the difference was not statistically significant (29.4% vs.24.8%,P＞0.05).Conclusion The G allele in rs1330344 of COX-1 gene in patients with ischemic cardiovascular disease is associated with a higher risk of aspirin resistance and a higher incidence of cardiovascular events after aspirin use,and a lower benefit from oral aspirin antiplatelet therapy.There was no significant correlation between the C allele at rs20714 of COX-2 gene and aspirin resistance or recurrence rate of cardiovascular events after aspirin administration. |
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