切换至 "中华医学电子期刊资源库"

中华诊断学电子杂志 ›› 2021, Vol. 09 ›› Issue (01) : 46 -50. doi: 10.3877/cma.j.issn.2095-655X.2021.01.011

所属专题: 文献

临床研究

内蒙古包头地区急性缺血性脑卒中患者CYP2C19基因多态性分析
尹燕茹1, 刘国荣1,(), 潘晓华1   
  1. 1. 014000 包头医学院中心临床医学院 包头市中心医院神经内科
  • 收稿日期:2020-07-06 出版日期:2021-02-10
  • 通信作者: 刘国荣

Analysis of CYP2C19 gene polymorphism in ischemic stroke patients in Baotou area, Inner Mongolia

Yanru Yin1, Guorong Liu1,(), Xiaohua Pan1   

  1. 1. Department of Neurology, Central Clinical College of Baotou Medical College Central Hospital of Baotou, Baotou 014000, China
  • Received:2020-07-06 Published:2021-02-10
  • Corresponding author: Guorong Liu
引用本文:

尹燕茹, 刘国荣, 潘晓华. 内蒙古包头地区急性缺血性脑卒中患者CYP2C19基因多态性分析[J/OL]. 中华诊断学电子杂志, 2021, 09(01): 46-50.

Yanru Yin, Guorong Liu, Xiaohua Pan. Analysis of CYP2C19 gene polymorphism in ischemic stroke patients in Baotou area, Inner Mongolia[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(01): 46-50.

目的

分析内蒙古包头地区急性缺血性脑卒中(IS)患者氯吡格雷相关基因CYP2C19多态性的分布情况及突变频率。

方法

收集2018年10月至2019年10月在包头市中心医院神经内科因急性IS接受治疗的280例患者的全血标本,检测CYP2C19基因型,按照年龄、性别等因素将被研究者分组,比较各组之间CYP2C19基因型及氯吡格雷代谢类型的分布。

结果

检测得到的基因型共7种,CYP2C19*1/*1,CYP2C19*1/*2,CYP2C19*2/*2,CYP2C19*1/*3,CYP2C19*2/*3,CYP2C19*1/*17,CYP2C19*2/*17,基因型分布频率分别为39.28%(110/280),38.93%(109/280),10.00%(28/280),7.14%(20/280),2.86%(8/280),1.43%(4/280),0.36%(1/280)。其中CYP2C19*1/*17属于超快代谢型,CYP2C19*1/*1属于快代谢型,CYP2C19*1/*2、CYP2C19*1/*3、CYP2C19*2/*17属于中等代谢型,CYP2C19*2/*2、CYP2C19*2/*3属于慢代谢型,4种代谢类型分布频率分别为1.43%(4/280),39.29%(110/280),46.43%(130/280)和12.86%(36/280)。CYP2C19基因多态性在不同性别间比较,差异无统计学意义(P=0.532);氯吡格雷代谢类型在不同性别间比较,差异无统计学意义(χ2=0.96,P=0.810);氯吡格雷代谢类型在男性(H=3.05,P=0.550)、女性(H=1.90,P=0.755)不同年龄段中分布比较,均差异无统计学意义。

结论

内蒙古包头地区急性IS患者氯吡格雷相关基因多态性主要以CYP2C19*1/*1为主,氯吡格雷代谢类型以中等代谢型为主,多数人对氯吡格雷有抵抗现象,氯吡格雷代谢类型在同性别不同年龄段无差异。

Objective

To analyze the distribution and mutation frequency of clopidogrel-related gene polymorphism CYP2C19 in the ischemic stroke (IS) patients in Baotou area, Inner Mongolia.

Methods

Whole blood samples were collected from 280 patients who were treated for IS in the Neurology Department of Baotou Central Hospital from October 2018 to October 2019. CYP2C19 genotypes were detected. The researchers were divided into different groups according to age, sex and other factors, and the distribution of CYP2C19 genotypes and clopidogrel metabolic types were compared among the groups.

Results

Seven genotypes were detected, CYP2C19*1/*1, CYP2C19*1/*2, CYP2C19*2/*2, CYP2C19*1/*3, CYP2C19*2/*3, CYP2C19*1/*17, CYP2C19*2/*17, and the genotype distribution frequencies were 39.28%(110/280), 38.93%(109/280), 10.00%(28/280), 7.14%(20/280), 2.86%(8/280), 1.43%(4/280), and 0.36%(1/280), respectively. CYP2C19*1/*17 belonged to super fast metabolism and CYP2C19* 1/*1 belonged to faster metabolism, CYP2C19*1/*2, CYP2C19*1/*3, CYP2C19*2/*17 belonged to intermediary metabolism and CYP2C19*2/*2, CYP2C19*2/*3 belonged to slow metabolism. The metabolic frequencies of the 4 types were 1.43%(4/280), 39.29%(110/280), 46.43%(130/280) and 12.86%(36/280). The comparison of CYP2C19 gene polymorphisms between different genders showed no significant difference (P=0.532). There was no significant difference in the distribution of clopidogrel metabolism between different genders (χ2=0.96, P=0.810), and there was no significant difference among different age groups in males (H=3.05, P=0.550) and females (H=1.90, P=0.755).

Conclusions

The polymorphism of clopidogrel gene in neurology patients in Baotou is mainly CYP2C19*1/*1, and the metabolic type of clopidogrel is mainly intermediate type, indicating that most people were resistant to clopidogrel. The metabolic type of clopidogrel is not different between different age groups in the same gender.

表1 缺血性脑卒中患者不同CYP2C19基因型在不同性别中的分布比较(例,%)
表2 缺血性脑卒中患者不同氯吡格雷代谢类型在不同性别中的分布比较(例,%)
表3 缺血性脑卒中患者不同年龄段氯吡格雷代谢类型在不同性别中的分布比较(例,%)
[1]
严骏,翁方中,戴伟,等.CYP2C19基因多态性与缺血性脑卒中发病及预后的相关性[J].中国老年学杂志,2019,39(21):5187-5191.
[2]
宁来轩.氯吡格雷联合阿司匹林治疗短暂性脑缺血发作的疗效观察[J].中国实用神经疾病杂志,2019,22(12):1358-1363.
[3]
利程,陈文礼,李亚男,等.珠中江地区脑卒中患者CYP2C19基因多态性差异性分布[J].今日药学,2019,29(9):626-628,632.
[4]
李笑笑,吕佳宁,范薇.CYP2C19基因多态性对氯吡格雷药效的影响[J].中国临床神经科学,2016,24(2):225-232.
[5]
Bozzi LM, MitcheliI BD, Lewis JP,et al. The pharmacogenomics of anti-platelet intervention(PAPI)study:variation in platelet response toclopidogrel and aspirin[J].Curr Vasc Pharmacol,2016,14(1):116-124.
[6]
Singh M, Thapa B, Arora R.Clopidogrel pharmacogenetics and its clinical implications[J].Am J Ther,2010,17(3):e66-e73.
[7]
Lee JH, Basith S, Cui M, et al. In silico prediction of multiple-category classification model for cytochrome P450 inhibitors and non-inhibitors using machine-learning method.[J].SAR and QSAR Environ Res,2017,28(10):863-874.
[8]
胡波.CYP2C19基因多态性对不同种族人群服用氯吡格雷疗效的影响[C]//中华医学会,中华医学会神经病学分会.中华医学会第十八次全国神经病学学术会议论文汇编(上),成都,2015:178-179.
[9]
Dehbozorgi M, Behnam K, Iman H, et al. Prevalence of the CYP2C19*2 (681 G>A),*3 (636 G>A) and*17 (-806 C>T) alleles among an Iranian population of different ethnicities[J].Mol Med Rep,2018,17(3):4195-4202.
[10]
吴亚哲,陈伟伟.中国脑卒中流行概况[J].心脑血管病防治,2016,16(6):410-414.
[11]
Antithrombotic Trialists′ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death,myocardial infarction,and stroke in high risk patients[J].BMJ,2002,324(7329):71-86.
[12]
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志,2015,48(4):258-273.
[13]
孙新帅,冯青俐.氯吡格雷联合阿司匹林在TIA治疗和二级预防中的应用观察[J].中国实用神经疾病杂志,2009,12(10):30-32.
[14]
Milionis HJ, Gerotziafas G, Kostapanos MS,et al.Clopidogrel vs.aspirin treatment on admission improves 5-year survival after a first-ever acute ischemic stroke.Data from the Athens Stroke Outcome Project[J].Arch Med Res,2011,42(6):443-450.
[15]
任宏生,朱兴雷.氯吡格雷防治动脉粥样硬化缺血性疾病的研究进展[J].心血管病学进展,2006,27(3):274-281.
[16]
Wang YJ, Liu M, Pu CQ.2014 Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack[J].Int J Stroke,2017,12(3):302-320.
[17]
Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2014,45(7):2160-2236.
[18]
何艳茹,党爱民.阿司匹林及氯吡格雷抵抗与基因多态性的研究进展[J].中华高血压杂志,2017,25(11):1084-1086.
[19]
Uchiyama S.Clopidogrel resistance:identifying and overcoming a barrier to effective antiplatelet treatment[J].Cardiovas Ther,2011,29(6):e100-e111.
[20]
Fefer P, Shlomi M.The genetic basis of platelet responsiveness to clopidogrel.A critical review of the literature[J].Thromb Haemost,2011,106(2):203-210.
[21]
顾永丽,孙增先.阿司匹林抵抗与氯吡格雷抵抗的研究进展[J].中国医院药学杂志,2016,36(10):866-869.
[22]
Brown SA, Pereira N. Pharmacogenomic impact of CYP2C19 variation on clopidogrel therapy in precision cardiovascular medicine[J].J Pers Med,2018,8(1):8.
[23]
Zhong ZX, Hou JY, Li B, et al. Analysis of CYP2C19 genetic polymorphism in a Large Ethnic Hakka population in Southern China[J].Med Sci Monit,2017(23):6186-6192.
[24]
莫延红,牛璇,张兆辉.CYP2C19基因多态性对临床常见药物代谢的影响[J].卒中与神经疾病,2019,26(4):499-507.
[25]
张爱玲,胡欣,杨莉萍.亚洲健康人群CYP2C19基因型发生率的合并分析[J].中国循证医学杂志,2014,14(4):427-434.
[26]
李静,郑伶利,陈静,等.基因突变检测在个体化用药中的研究进展[J].现代药物与临床,2018,33(4):1002-1008.
[27]
庄献博,王未飞,单广振,等.青中年缺血性脑卒中患者血清抗心磷脂抗体免疫球蛋白G、白细胞介素-17、超敏C反应蛋白水平变化的意义[J/CD].中华诊断学电子杂志,2017,5(1):51-54.
[1] 周容, 张亚萍, 廖宇, 程晓萍, 管玉龙, 潘广玉, 闫杰, 王贤芝, 苟中山, 潘登科, 李巅远. 超声在基因编辑猪-猴异种并联式心脏移植术中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 617-623.
[2] 葛睿, 陈飞, 李杰, 李娟娟, 陈涵. 多基因检测在早期乳腺癌辅助治疗中的应用价值[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 257-263.
[3] 王聪, 李云涛, 唐甜甜, 王鑫蕊, 吕鑫, 范志刚. 多基因检测对激素受体阳性、HER-2阴性乳腺癌新辅助化疗疗效预测的研究进展[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 292-296.
[4] 费一鸣, 刘卓, 张丽娟. 组学分析在早产分子机制中的研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 504-510.
[5] 铁晓玲, 刘毅, 杨颖, 车凤玉. Rubinstein-Taybi综合征先证者3例并文献复习[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 452-459.
[6] 奚卫, 王闻卿, 刘玥, 王亚楠, 许学斌. 胃肠炎继发脓毒症感染创伤弧菌ST14514的病原学诊断与文献病例回顾分析[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(05): 293-302.
[7] 丁志翔, 于鹏, 段绍斌. 血浆BRAF基因检测对腹腔镜右半结肠癌D3根治术中行幽门淋巴结清扫的指导价值[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 570-573.
[8] 刘文竹, 唐窈, 刘付臣. 诱导多潜能干细胞在神经肌肉疾病研究中的应用进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 367-373.
[9] 王庭宇, 邵联波, 刘珊, 沈振亚. Stanford A 型主动脉夹层相关基因KIF20A 的共表达网络构建及作用靶点分析[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(05): 303-312.
[10] 李京, 牛博, 刘晓蓓, 魏新雪, 黄荣. circ-SESN2 沉默靶向调控miRNA-23a-5p/ULK1 在神经细胞氧化应激损伤中的作用机制研究[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 263-272.
[11] 薛文, 刘卓, 贾卫华, 张小义, 刘进, 王爱国, 冯志刚, 杨鑫, 田祺, 段虎斌. 大鼠脊髓损伤后降钙素基因相关肽及神经元钙超载的变化及相关性分析[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(04): 198-205.
[12] 陈倩倩, 袁晨, 刘基, 尹婷婷. 多层螺旋CT 参数、癌胚抗原、错配修复基因及病理指标对结直肠癌预后的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 507-511.
[13] 丁富贵, 吴泽涛, 董卫国. 家族性腺瘤性息肉病临床特征及生物信息学分析[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 512-518.
[14] 李玺, 蔡芸莹, 张永红, 苏恒. 假性软骨发育不全合并1型糖尿病一例[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 518-520.
[15] 李佳佳, 李凌华, 吕诗韵, 冯凯, 刘琳珊, 钟海丹, 颜婵, 刘聪. 广州市病毒学抑制失败HIV/AIDS患者的耐药特征及影响因素分析[J/OL]. 中华卫生应急电子杂志, 2024, 10(04): 207-212.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?