CYP2C19基因多态性和风险评分与经皮冠状动脉介入术后预后的关系

摘要

目的 对CYP2C 19的基因多态性与风险评分对冠状动脉介入术(PCI)预后的关系进行分析探讨.方法 从2012年3月至2012年7月接收的行PCI患者中随机抽选40例,入院之前统一抽血检查CYP2C19基因,将患者按CYP2C19基因型分为三组:慢代谢型患者,中代谢型患者,和快代谢型患者.结果 经过检测,PRI VASP≥50％的患者为6例,PRI VASP＜50％的患者为34例,两组间PRI VASP比为(55.97±2.98)比(44.01±4.16),两组比较差异有统计学意义(P＜0.05).通过多元回归分析对导致PCI术后不良终点事件的因素进行分析得出:老龄、CYP2C19慢性代谢、2型糖尿病、左室射血分值、肾功能不全等5项因素为高危险因素.结论 对于慢代谢者可以通过增加氯吡格雷药物剂量,并联合给服阿司匹林以预防心血管事件发作.%Objective To investigate the relation between CYP2C19 polymorphisms and risk score and prognosis after percutaneous coronary intervention (PCI).Methods From March in 2012 to July in 2012 we randomly selected 40 patients who received PCI treatment and took their blood for the test of CYP2C 19 before admission.The CYP2C 19 genotypes were divided into three groups:extensive metabolisms,medium metabolisms and poor metabolisms.Results The PRI VASP ≥ 50％ of the patients in 6 cases,the PRI VASP ＜ 50％ of the patients in 34 cases,between the two groups of PRI VASP ratio of (55.97 ± 2.98) than (44.01-± 4.16),the difference had statistical significance (P ＜ 0.05).Through multiple regression analysis,this paper analyzes the factors which lead to the PCI postoperative adverse end point events concluded:aging,CYP2C19 poor metabolism,T2DM,LVEF,Renal insufficiency,the five factors for the high risk factors.Conclusion For patients with poor metabolism we can increase the dose of clopidogrel and combining Aspirin to prevent heart attacks.