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| CYP2C19基因检测对冠心病患者抗血小板聚集治疗的临床意义 |
| Clinical significance of CYP2C19 gene detection in the treatment of antiplatelet aggregation in patients with coronary heart disease |
| 投稿时间：2024-10-29 修订日期：2024-10-29 |
| DOI： |
| 中文关键词: CYP2C19基因多态性 冠心病；血小板聚集治疗 依从性 |
| 英文关键词: CYP2C19 gene polymorphism Coronary heart disease Platelet aggregation therapy Compliance |
| 基金项目:安徽省高校科研项目（2022AH050641），院科研培育基金项目（2024YKJ13） |
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| 中文摘要: |
| 目的：评估检测CYP2C19基因多态性对冠心病患者抗血小板聚集治疗临床意义。方法：收集某院2020年10月至2021年10月行CYP2C19基因检测的住院患者共253例，排除非冠心病患者及资料不完整的病历，最终纳入119例患者，分析CYP2C19基因多态性分布、对治疗方案的影响，并用多因素logistic回归分析临床医师按照指南调整治疗方案的因素。结果：119例患者，快代谢型（CYP2C19*1/*1）40例，占比33.6%；中间代谢型（CYP2C19*1/*2,*1/*3）60例，占比50.4%；慢代谢型（CYP2C19*2/*2,*2/*3,*3/*3）19例，占比16.0%。CYP2C19*1、*2、*3频率分别为58.8%、40.0%、4.2%。中慢代谢氯吡格雷组与替格瑞洛组临床基本资料中的LDL-C水平比较，有统计学差异（z=-2.202, P=0.028）；多因素logistics分析结果显示，基因类型非医师按照指南调整治疗方案依从性的独立预测因子。结论：针对冠心病的患者，通过检测CYP2C19基因多态性来指导其抗血小板聚集治疗的临床意义仍待商榷。 |
| 英文摘要: |
| Objective: To evaluate the clinical significance of detecting CYP2C19 gene polymorphism in the treatment of antiplatelet aggregation in patients with coronary heart disease. Methods: A total of 253 hospitalized patients with CYP2C19 gene testing from October 2020 to October 2021 were collected, non-coronary heart disease patients and incomplete medical records were excluded, and 119 patients were finally included to analyze the distribution of CYP2C19 gene polymorphisms , the impact of the treatment plan. and use multi-factor logistic regression to analyze the factors of the clinician adjusting the treatment plan according to the guidelines. Results: Among 119 patients, 40 cases of fast metabolic (CYP2C19*1/*1), accounting for 33.6%; 60 cases of intermediate metabolic (CYP2C19*1/*2,*1/*3), accounting for 50.4%; and 19 cases of slow metabolic (CYP2C19*2/*2,*2/*3,*3/*3), accounting for 16.0%. The CYP2C19*1,*2 and*3 frequencies are 58.8%, 40.0% and 4.2% respectively. There was a statistically significant difference (z=-2.202, P=0.028) in the LDL-C levels in the clinical basic data between the clopidogrel group with moderate to slow metabolism and the ticagrelor group; The results of multivariate logistic analysis showed that gene types were not independent predictors of treatment adherence adjusted by physicians according to guidelines. Conclusion: The clinical significance of detecting CYP2C19 gene polymorphism to guide antiplatelet aggregation therapy in patients with coronary heart disease remains to be discussed. |
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