荧光 PCR 法和 PCR 熔解曲线法对经皮冠状动脉介入术术后患者 CYP2C19基因多态性诊断

摘要

Objective After treatment of coronary heart disease in patients with PCI clopidogrel platelet aggregation,and to study the effect of CYP2C19 gene polymorphism on the curative effect.Method The patients with coronary heart disease who underwent PCI operation in the Department of Cardiology of our hospital were selected.The genotype of CYP2C19 were detected preoperatively by fluorescence PCR method and PCR melting curve method,Whether the presence of clopidogrel resistance was judged by the presence of CYP2C19 functional loss alleles (* 2 or * 3).Results In the selected 28 patients who underwent coronary stent implantation,A total of 15 patients (53.6%)were lost in CYP2C19 function.Which carry * 2 alleles in 12 pa-tients (42.9%),including heterozygous type 10 cases (35.7%)and homozygous in 2 cases (7.1%);carrying * 3 allele of patients in 5 cases (17.9%),including heterozygous type 4 cases (14.3%) and homozygous 1 case (3.6%).Conclusion The loss of CYP2C19 function alleles can lead to the decrease of the antiplatelet effect of clopidogrel,which pro-vides a strong basis for clinical treatment.%目的：经皮冠状动脉介入术（PCI）治疗冠心病后服用氯吡格雷抗血小板聚集的患者中，研究肝脏细胞色素 P4502C19（CYP2C19）基因多态性对其疗效的影响。方法：选取行 PCI 术的冠心病患者，术前采用荧光 PCR 法和PCR 熔解曲线法分别进行 CYP2C19基因型检测，根据患者是否存在 CYP2C19功能丧失性等位基因（*2或*3）判断是否存在氯吡格雷抵抗现象。结果：在入选的28例接受了冠状动脉支架植入的患者中，CYP2C19功能丧失性等位基因共15例（53.6％），其中携带*2位点等位基因的患者12例（42.9％），包括杂合型10例（35.7％）及纯合型2例（7.1％）；携带*3位点等位基因的患者5例（17.9％），包括杂合型4例（14.3％）及纯合型1例（3.6％）。结论：携带CYP2C19功能丧失性等位基因可导致氯吡格雷抗血小板作用减弱，为临床治疗提供有力依据。