CYP2C19基因多态性及血小板高反应性对急性冠状动脉综合征患者PCI后临床缺血事件的影响

摘要

Objective To study the effects of CYP2C19 polymorphism and platelet hyperresponsiveness on clinical ischemic events after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods From January 2016 to January 2018, 240 ACS patients who received PCI in Department of Cardiology of Meishan People's Hospital were studied, and all the patients were followed up for 6 months. According to whether the ischemic events occurred, the patients were divided into the event group (52 cases) and the non-event group (188 cases).The general data, biochemical index levels, CYP2C19 polymorphism and platelet hyperresponsiveness of the two groups were compared, and multiple Logistic regression analysis of clinical ischemic events after PCI was performed. Results The proportion of smokers and White blood cell(WBC) level in the event group was higher than the non-event group (P＜0.05). The proportion of CYP2C19 intermediate metabolic + slow-metabolizing genes and platelet hyperresponsiveness in patients of the event group was higher than the non-event group (all P＜0.05). Multiple Logistic regression analysis showed that smoking, WBC, intermediate metabolic +slow-metabolizing type CYP2C19 gene and platelet hyperresponsiveness were all independent risk factors for clinical ischemic events after PCI in ACS patients (all P＜0.05). Conclusion CYP2C19 gene polymorphism and platelet hyperresponsiveness are associated with clinical ischemic events after PCI in patients with ACS, suggesting that scientific interventions for these factors may improve patient outcomes.%目的 研究CYP2C19基因多态性及血小板高反应性对急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后临床缺血事件的影响.方法 选取2016年1月至2018年1月于眉山市人民医院心血管内科接受PCI术治疗的ACS患者240例进行研究,对所有患者进行为期6个月的随访,按照患者是否发生缺血事件分为事件组52例与非事件组188例.分别比较两组患者的一般资料、各项生化指标水平、CYP2C19基因多态性及血小板高反应性情况,并做PCI术后临床缺血事件的多因素Logistic回归分析.结果 事件组吸烟人数占比及白细胞计数(WBC)水平较非事件组更高(P＜0.05).事件组患者CYP2C19中间代谢型+慢代谢型基因、血小板高反应人数占比相比非事件组明显更高(P均＜0.05).多因素Logistic回归分析结果显示,吸烟、WBC、中间代谢型+慢代谢型CYP2C19基因、血小板高反应性均是ACS患者PCI术后临床缺血事件的独立危险因素(P均＜0.05).结论 CYP2C19基因多态性及血小板高反应性与ACS患者PCI术后临床缺血事件发生相关.