Correlation analysis of the CYP2C19 gene methylation and thromboelastographic parameters in patients with hypertensive intracerebral hemorrhage treated with hemostatic agents
Objective To investigate the correlation between the CYP2C19 gene methylation and thromboelastographic(TEG)parameters in patients with hypertensive intracerebral hemorrhage treated with hemostatic agents.Methods Patients with hypertensive intracerebral hemorrhage were divided into group A(25 cases of fast metabolic type),group B(32 cases of intermediate metabolic type),and group C(8 cases of slow metabolic type)according to the CYP2C19 genotyping.TEG parameters,including the R value,K value,α-Angle,maximal amplitude(MA)and coagulation index(CI)were measured using the by the Xifensi thromboelastographic instrument(CFMS LEPU-Auto 8).The methylation level of CYP2C19 promoter was detected by bisulfite sequencing PCR(BSP).Results Compared with those before treatment,patients in group A presented the normal ranges of K value and CI,an increase in the α-Angle by 10°,an increase in the MA by 17.73mm,improved disease condition and controlled bleeding after individualized medication.Patients in group B presented an increase in the R value by 5.39 min(within the normal range),an increase in CI by 1.62 and improved disease condition.TEG parameters in group C were not significantly changed after treatment,and all of them did not recover into the normal ranges,suggesting the unsatisfactory efficacy.The correlation analysis of the DNA methylation level in the promoter region of the CYP2C19 gene and TEG parameters showed that the mean correlation coefficient in group A and B was 0.21(P<0.05),and 0.3(P<0.05),respectively,which was not correlated in group C(P>0.05).It is indicated that the methylation level of the CYP2C19 gene was correlated with TEG parameters,especially for the intermediate metabolic type and the fast metabolic type,but no correlation for the slow metabolic type.Conclusion The methylation level of the CYP2C19 gene and TEG parameters can be used to monitor the coagulation function of patients with hypertensive intracerebral hemorrhage treated with hemostatic agents,showing the predicting value in the efficacy of hemostatic agents.
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维普
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