| 余芬,何静.氯吡格雷在老年缺血性脑卒中患者的应用及CYP2C19 基因多态性对预后的影响[J].安徽医药,2017,21(11):2066-2068. |
| 氯吡格雷在老年缺血性脑卒中患者的应用及CYP2C19 基因多态性对预后的影响 |
| Application of clopidogrel in elderly patients with ischemic stroke and influence of CYP2C19 gene polymorphism in prognosis |
| 投稿时间：2017-01-18 |
| DOI： |
| 中文关键词: 氯吡格雷 老年缺血性脑卒中 CYP2C19基因多态性 |
| 英文关键词: Clopidogrel Elderly patients with ischemic stroke CYP2C19 gene polymorphism |
| 基金项目:武汉市卫计委科研基金资助项目(WX15C12)氯吡格雷在老年缺血性脑卒中患者的应用及CYP2C19 基因多态性对预后的影响余芬,何静 (武汉市第三医院神经内科,湖北 武汉 430060)氯吡格雷在老年缺血性脑卒中患者的应用及CYP2C19 基因多态性对预后的影响余芬,何静 Application of clopidogrel in elderly patients with ischemic stroke and influence of CYP2C19 gene polymorphism in prognosisYU Fen,HE Jing |
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| 中文摘要: |
| 目的 探讨氯吡格雷在老年缺血性脑卒中患者中的应用及细胞色素P4502C19(CYP2C19)基因多态性对预后的影响。方法 选取收治的老年缺血性脑卒中患者144例,依据氯吡格雷抵抗情况将这些患者分为抵抗组(n=45)和非抵抗组(n=99)两组,测定两组患者的血小板聚集功能并检测其基因型,然后对2个单核苷酸多态性(SNPs)的等位基因频率及基因型频率、两组患者的2个SNPs分布情况进行统计分析。结果 CYP2C19(636G>A,rs4986893)(681G>A,rs4244285)等位基因及基因频率均和Hardy-Weinberg相符(P>0.05)；抵抗组患者的CYP2C19*2(rs4244285)GG型分布率显著低于非抵抗组(P<0.05),GA+AA型分布率显著高于非抵抗组(P<0.05),且GA+AA型分布率显著高于GG型(P<0.05),但两组患者的CYP2C19*3(rs4986893)GG型、AG+AA型分布率之间均差异无统计学意义(P>0.05)。结论 老年缺血性脑卒中患者的氯吡格雷抵抗和CYP2C19*2(rs4244285)GA+AA型关系密切,检测该基因型能够为氯吡格雷的临床科学应用提供有效指导,值得临床充分重视。 |
| 英文摘要: |
| Objective To investigate the application of clopidogrel in elderly patients with ischemic stroke and influence of CYP2C19 gene polymorphism in prognosis. Methods One hundred and forty-four cases of elderly patients with ischemic stroke in department of neurology,Wuhan Third Hospital from May 2014 to May 2016 were selected.These patients were assigned into resistance group(n=45) and non-resistance group(n=99),according to the situation of clopidogrel resistance.The platelet aggregation of the two groups were measured and the genotype were detected.then the 2 SNPs allele frequency distribution,genotype frequency of 2 SNPs of the two groups were statistically analyzed. Results CYP2C19(636G>A,rs4986893)(681G>A,rs4244285) allele and gene frequency were consistent with Hardy-Weinberg(P>0.05).The CYP2C19*2(rs4244285) GG distribution rate of the resistance group was significantly lower than the non-resistance group(P<0.05),the GA+AA distribution rate was significantly higher than the non-resistance group(P<0.05),and the GA+AA distribution rate was significantly higher than the GG(P<0.05).However,the differences of the CYP2C19*3(rs4986893) GG type and AG+AA type distribution rates between the two groups were not significant(P>0.05). Conclusions The relationship between clopidogrel resistance and GA+AA(rs4244285) CYP2C19*2 of the elderly patients with ischemic stroke is close,the detection of the genotype can provide an effective guidance for the clinical application of clopidogrel,which is worthy of the clinical full attention. |
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