摘要
目的探讨CYP2C19基因检测在缺血性脑卒中患者氯吡格雷用药中的应用效果。方法选取2019年2月至2022年2月江西省抚州市第一人民医院收治的80例缺血性脑卒中患者作为研究对象,按照电脑编号随机数字表法分为研究组及对照组,每组40例。所有受试者入院后均接受常规治疗。此外,对照组常规给药氯吡格雷治疗。研究组则均完成CYP2C19基因多态性检测,并根据CYP2C19基因型差异适当调整氯吡格雷剂量以及替换抗血小板药物治疗。对所有受试者均进行为期6个月的随访观察,随访方式为门诊复查、电话询问等。比较两组患者治疗前,治疗3、6个月后的改良Rankin量表(mRS)评分以及脑血管不良事件发生情况(涵盖复发、短暂性脑缺血发作、心源性死亡以及非致死性心肌梗死等)。结果整体分析发现,两组患者mRS评分组间、时间点及交互作用比较,差异均有统计学意义(P<0.05)。两组患者治疗后3、6个月mRS评分低于本组治疗前,治疗后6个月mRS评分低于本组治疗后3个月,差异有统计学意义(P<0.05);研究组治疗后3、6个月mRS评分低于对照组,差异有统计学意义(P<0.05)。研究组随访期间复发、短暂性脑缺血发作、心源性死亡以及非致死性心肌梗死发生率均低于对照组,差异有统计学意义(P<0.05)。结论根据CYP2C19基因多态性检测结果调整氯吡格雷用药方案或替换抗血小板药物治疗,可有效改善缺血性脑卒中患者预后,降低脑血管不良事件发生风险。
Objective To investigate the application effect of CYP2C19 gene detection on Clopidogrel in patients with ischemic stroke.Methods A total of 80 patients with ischemic stroke admitted to First People's Hospital of Fuzhou from February 2019 to February 2022 were selected as the research objects,they were divided into study group and control group according to computer random number table method,with 40 cases in each group.All subjects received conventional treatment after admission.In addition,the control group was routinely treated with Clopidogrel.In the study group,CYP2C19 gene polymorphism detection was completed,and Clopidogrel dose was appropriately adjusted and antiplatelet drug therapy was replaced according to CYP2C19 genotype differences.All subjects were followed up for 6 months by outpatient review and telephone inquiry.Modified Rankin scale(mRS)score and cerebrovascular adverse events(including recurrence,transient ischemic attack,cardiac death and non-fatal myocardial infarction)were compared between the two groups before and after 3 and 6 months of treatment.Results The overall analysis showed that there were statistically significant differences between groups,time points and interaction of mRS scores between the two groups(P<0.05).The mRS scores of the two groups at 3 and 6 months after treatment were lower than those before treatment,and the mRS scores of two groups at 6 months after treatment were lower than those at 3 months after treatment,with statistical significances(P<0.05).The mRS scores of the study group were lower than those of the control group at 3 and 6 months after treatment,and the differences were statistically significant(P<0.05).During the follow-up period,the incidences of recurrence,transient ischemic attack,cardiac death and non-fatal myocardial infarction in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Adjusting the regimen of Clopidogrel or replacing antiplatelet agents according to the resu
作者
吴莉
钟华胜
赵欢田
付志平
黄坤
张洋萍
孔杨琴
胥海燕
WU Li;ZHONG Huasheng;ZHAO Huantian;FU Zhiping;HUANG Kun;ZHANG Yangping;KONG Yangqin;XU Haiyan(Department of Neurology,First People's Hospital of Fuzhou,Jiangxi Province,Fuzhou344000,China)
出处
《中国当代医药》
CAS
2023年第31期64-67,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202212872)。
