CYP2C19基因多态性与丁苯酞治疗急性脑梗死疗效的关系
Relationship between CYP2C19 gene polymorphism and curative effect of butyphthalide in acute cerebral infarction
马青川 1穆妮 2吴熙 1颜亮亮1
作者信息
- 1. 天水市第一人民医院医学检验科,天水 741000
- 2. 天水市第一人民医院病理科,天水 741000
- 折叠
摘要
目的:探讨细胞色素P450 2C19(CYP2C19)基因多态性与丁苯酞治疗急性脑梗死(ACI)疗效的关系.方法:选取2023年2月―2023年12月收治的216例急性脑梗死患者作为研究对象,所有患者均给予丁苯酞治疗,检测治疗7 d后丁苯酞血药浓度,根据美国国立卫生研究院卒中量表评分(NHISS)分为有效组(NHISS评分降低≥45%,n=112)和无效组(NHISS评分降低<45%,n=104),采用高通量基因分型技术检测CYP2C19基因多态性,并采用多因素Logistic回归分析CYP2C19基因多态性对丁苯酞治疗ACI患者疗效的影响.结果:治疗7 d后,NIHSS评分、mRS评分低于治疗前,ADL评分高于治疗前5);治疗7 d后,快代谢型丁苯酞血药浓度高于中间代谢型和慢代谢型;有效组CYP2C19*2位点GG基因基因频率和CYP2C19*3位点GG基因基因频率高于无效组;采用二元Logistic回归分析,房颤(OR=2.366,P=0.019)、治疗前NIHSS评分(OR=2.358,P=0.016)、CYP2C19*2(OR=4.423,P<0.001)、CYP2C19*3(OR=2.316,P=0.028)均为影响丁苯酞治疗ACI患者疗效的独立危险因素.结论:CYP2C19基因多态性与丁苯酞治疗急性脑梗死疗效有关,携带A等位基因疗效更差.
Abstract
Objective To explore the relationship between gene polymorphism of cytochrome P450 2C19(CYP2C19)and curative effect of butyphthalide in acute cerebral infarction(ACI).Methods A total of 216 patients with ACI were enrolled as the research objects between February and December 2023.All patients were treated with butyphthalide,and blood concentra-tion of butyphthalide was detected after 7d of treatment.According to scores of National Institutes of Health Stroke Scale(NHISS),patients were divided into effective group(NHISS score decreased by≥45%,n=112)and ineffective group(NHISS score de-creased by<45%,n=104).CYP2C19 gene polymorphisms were detected by high-throughput genotyping technique.The ef-fects of CYP2C19 gene polymorphisms on curative effect of butyphthalide in ACI patients were analyzed by multivariate Logis-tic regression analysis.Results After 7d of treatment,scores of NIHSS and mRS were decreased,and ADL score was increased.After 7d of treatment,blood concentration of fast-metabolism butyphthalide was higher than that in intermediate-metabolism and slow-metabolism butyphthalide.The frequencies of GG gene at CYP2C19*2 and CYP2C19*3 loci in effective group were higher than those in ineffective group.Binary Logistic regression analysis showed that atrial fibrillation(OR=2.366,P=0.019),NIHSS score before treatment(OR=2.358,P=0.016),CYP2C19*2(OR=4.423,P<0.001)and CYP2C19*3(OR=2.316,P=0.028)were all independent risk factors affecting the curative effect of butyphthalide in ACI patients.Conclusion The poly-morphisms of CYP2C19 gene are related to the curative effect of butyphthalide in ACI,and curative effect is worse in patients with A allele.
关键词
急性脑梗死/细胞色素P450/2C19/基因多态性/丁苯酞Key words
acute cerebral infarction/cytochrome P450 2C19/gene polymorphism/butyphthalide引用本文复制引用
基金项目
甘肃省自然科学基金项目(22JR5RE1038)
出版年
2024
NETL
NSTL
万方数据