摘要
目的探讨CYP2C19基因检测指导缺血性脑卒中患者抗血小板个体化治疗临床价值。方法选取2017年6月~2019年6月期间收治的缺血性脑卒中患者76例,随机分为对照组和观察组,每组38例。所有患者均行CYP2C19基因型检测作为治疗指导依据,对照组行拜阿司匹林常规治疗,观察组行氯吡格雷或阿司匹林个体化治疗,随访1个月和6个月,观察两组新发缺血性脑血管事件发生率及出血事件发生率。结果随访1个月,观察组患者未发生新发缺血性脑血管事件、出血事件及脑血管病死亡情况,对照组发生率分别为5.26%、5.26%、0.00%,差异无统计学意义(P>0.05)。随访6个月,观察组新发缺血性脑血管事件0.00%、出血事件2.63%均低于对照组10.53%、15.79%,差异有统计学意义(P<0.05)。观察组脑血管病死亡0.00%与对照组0.00%,差异无统计学意义(P>0.05)。结论在缺血性脑卒中患者抗血小板治疗中行CYP2C19基因检测指导具有较高价值,可发现患者实际代谢情况,作为调整用药剂量的可靠依据,保证治疗有效性和安全性。
Objective To investigate the clinical value of CYP2C19 gene detection in the individualized anti-platelet treatment in patients with ischemic stroke.Methods A total of 76 patients who were treated with ischemic stroke between June 2017 and June 2019 in the hospital were included in the study.All of them were randomized into 2 groups,38 patients in each group.All of them were tested for CYP2C19 genotype as a treatment basis.The patients in control group received routine treatment with aspirin.The patients in observation group received individualized treatment with clopidogrel.The incidence of new ischemic cerebrovascular events and the incidence of hemorrhagic events were observed at 1 and 6 months follow-up.Results During the follow-up of 1 month,no new ischemic cerebrovascular events,hemorrhagic events and cerebrovascular disease death occurred in the observation group.The incidence of the control group was 5.26%,5.26%,and 0.00%,respectively(P>0.05).At the end of follow-up 6 months,in the observed group,incidence rate of new ischemic cerebrovascular events(0.00%)and bleeding events(2.63%)were lower than those of the control group 10.53%,15.79%(P<0.05).There was no significant difference in the death rate of cerebrovascular disease in the observation group(0.00%)and the control group(0.00%,P>0.05).Conclusion In the anti-platelet therapy of patients with ischemic stroke,the guidance of CYP2C19 gene detection has high value,and the actual metabolic status of the patient can be found.As a reliable basis for adjusting the dosage,the therapeutic effectiveness and safety are guaranteed.
作者
唐小荣
罗栋为
郭剑虹
杨湘伟
TANG Xiao-rong;LUO Dong-wei;GUO Jian-hong(Neurology Department of Chaozhou Central Hospital,Chaozhou,Guangdong 521000,China)
出处
《中国处方药》
2020年第1期143-144,共2页
Journal of China Prescription Drug
基金
潮州市科学技术局2017年市自筹经费类科技计划项目（2017GY15）
