对氧磷酶-1 Q192R基因多态性与r氯吡格雷抵抗的相关性

摘要

目的 探讨对氧磷酶-1(PON-1)Q192R基因多态性与氯吡格雷抵抗(CR)发生的相关性.方法 入选118例经冠状动脉造影或CT冠状动脉造影确诊的冠心病患者.给予充分氯吡格雷治疗后,应用富血小板血浆光学法测定患者服药后最大血小板聚集率.根据最大血小板聚集率将患者分成氯吡格雷抵抗组(CR组)和非氯吡格雷抵抗组(NCR组).应用MassARRAY时间飞行质谱技术对患者PON-1基因Q192R单核苷酸多态性位点进行基因分型,比较两组患者基因型分布情况以及不同基因型之间血小板聚集率的差异.结果 入选的118例患者中CR25例,NCR93例,CR发生率为21.2％.CR组RR、QR、QQ基因型频率分别为36.0％,52.0％,12.0％,NCR组分别为32.2％,57.0％,10.8％,两组间基因型频率分布差异无统计学意义(P>0.05);R、Q等位基因频率在两组间分别为:62.0％,60.8％和38.0％,39.2％,等位基因频率分布两组差异无统计学意义(P>0.05).结论 PON-1 Q192R基因多态性与CR的发生无相关性.%Objective To investigate the correlation between Paraoxonase-1 (PON-1) gene Q192R polymorphism and clopidogrel resistance (CR). Methods A total of 118 patients with coronary artery disease diagnosed by coronary angiography or coronary artery CT angiography were enrolled. Platelet aggregation rate was assessed by ADP-induced light-transmittance aggregometry after the patients received adequate clopidogrel pretreatment.The patients were divided into (clopidogrel resistance group (CR group) and non-clopidogrel resistance group (NCR group) according to the ADP-induced platelet aggregation rate. The gene of Q192R was detected by MassARRAY Time of Flight Mass Spectrometry.The genotypes and allele frequencies between the two groups were compared. Results According to the ADP-induced platelet aggregation rate,25 patients were defined as clopidogrel resistant and 93 as non-clopidogrel resistant.The incidence of clopidogrel resistance was 21.2％.Three frequencies of genotype RR,QR and QQ were 36. 0％,52. 0％ and 12. 0％ in CR group, and 32. 2％,57. 0％ and 10. 8％ in NCR group, respectively.The frequencies of Q and R allele in CR group were 62.0％ and 38.0％,and those in NCR group were 60.8％ and 39.2％.No significant differences in genotype and allele frequency were found between CR group and NCR group (P>0.05). Conclusion The PON-1 gene Q192R polymorphism is not associated with clopidogrel resistance in patients with CHD.