CYP2 C19基因多态性指导下氯吡格雷个体化治疗的研究进展

摘要

Clopidogrel requires transformation into an active metabolite by cytochrome P-450 enzymes for its antiplatelet effect.The genes encoding CYP enzymes are polymorphic, with common alleles conferring reduced function.Compared with loss-of-function CYP2C19 alleles and not carriers in the people with taking clopidogrel treatment, clopidogrel activates metabolites levels dropped significantly lead to platelet inhibition effect significantly lower, and major cardiovascular events and risk of stent thrombosis sharply increased.In this paper, the recent research progress in this field is reviewed.%氯吡格雷是一个无活性的前体药物，需要经过细胞色素P450酶代谢活化后才能发挥抗血小板的作用。而编码CYP酶的基因具有多态性，且大部分等位基因功能减弱。在使用氯吡格雷治疗的人群中，CYP2C19功能缺失型等位基因的携带者与未携带者相比，氯吡格雷活化代谢产物水平显著下降，从而导致血小板抑制效果明显下降，主要心血管事件发生率及支架血栓风险大幅增加。现就近年该领域的研究进展进行综述。