摘要
目的探讨老年冠心病并发2型糖尿病(T2DM)患者行经皮冠状动脉介入(PCI)治疗后CYP2C19基因多态性与氯吡格雷抗血小板作用的关系。方法选取2017年5月至2019年4月64例老年冠心病并发T2DM患者(并发T2DM组)及老年冠心病患者50例(冠心病组),所有患者均进行PCI治疗,治疗前后均口服氯吡格雷+阿司匹林。对比两组患者的CYP2C19基因多态性分布情况、氯吡格雷抵抗发生率、血小板抑制水平及主要不良心血管事件(MACE)发生率(随访6个月)。结果并发T2DM组患者CYP2C19基因多态性分布以中间代谢型为主,冠心病组以快代谢型为主(P<0.05);并发T2DM组弱代谢型患者氯吡格雷抵抗发生率明显高于冠心病组(P<0.05);中间、慢代谢型患者的血小板抑制率明显低于快代谢型,MACE发生率高于快代谢型(P<0.05)。结论 CYP2C19基因多态性检测对预测氯吡格雷抵抗发生率、血小板抑制率、MACE发生率具有重要意义。
Objective To investigate the relationship between CYP2 C19 gene polymorphism after PCI and anti-platelet effect of clopidogrel in patients with coronary heart disease complicated with T2 DM.Methods From May 2017 to April 2019,64 elderly patients with coronary heart disease complicated with T2 DM(combined with T2 DM group)and 50 elderly patients with coronary heart disease(coronary heart disease group)were enrolled.All patients underwent PCI.Oral clopidogrel+aspirin was given before and after treatment.The distribution of CYP2 C19 gene polymorphism,the incidence of clopidogrel resistance,the level of platelet inhibition and the incidence of major adverse cardiovascular events(MACE)were compared between the two groups(6 months follow-up).Results The distribution of CYP2 C19 gene polymorphism was mainly intermediate metabolic type in patients with T2 DM and fast metabolic type in patients with coronary heart disease(P<0.05).The incidence of clopidogrel resistance in patients with weak metabolic type in patients with T2 DM was significantly higher than that in patients with coronary heart disease(P<0.05).The platelet inhibition rate in patients with intermediate and slow metabolic type was significantly lower than that in patients with fast metabolic type,and the incidence of MACE was higher than that in fast metabolic type(P<0.05).Conclusions The detection of CYP2 C19 gene polymorphism is important for predicting the incidence of clopidogrel resistance,platelet inhibition rate and MACE incidence.
作者
郭玉梅
张琳
李海洲
马秀梅
Guo Yumei;Zhang Lin;Li Haizhou;Ma Xiumei(Department of Cardiology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China;Henan Provincial Cadre Rehabilitation Hospital,Zhengzhou 450003,China)
出处
《临床医学》
CAS
2019年第8期25-27,共3页
Clinical Medicine
基金
河南省医学科技攻关计划支撑基金项目(201602330)~~
