Antiplatelet Strategy and its Effect on Prognosis in Patients with Cerebral Infarction with Different CYP2C19 Genotypes
Objective To investigate the effect of clopidogrel antiplatelet therapy in patients with cerebral infarction of different CYP2C19 genotypes. Methods A total of 390 patients with cerebral infarction admitted to Yudu County People's Hospital from October 2021 to June 2023 were selected as the study subjects. According to the different genotypes of patients,they were divided into fast metabolic group (n=178),intermediate metabolic group (n=155) and slow metabolic group (n=57). All patients were treated with clopidogrel. The platelet aggregation rate,NIHSS score,ADL score,hemorheology and vascular endothelium[erythrocyte sedimentation rate (ESR),endothelin 1 (ET-1),nitric oxide (NO)]were compared among the three groups.Results After treatment,the platelet aggregation rate in the fast metabolic group was higher than that in the intermediate metabolic group and the slow metabolic group (P<0.05). The NIHSS score of the fast metabolic group was lower than that of the intermediate metabolic group and the slow metabolic group,and the ADL score was higher than that of the intermediate metabolic group and the slow metabolic group (P<0.05). The whole blood high shear viscosity,plasma viscosity,ESR and ET-1 levels in the fast metabolic group were lower than those in the intermediate metabolic group and the slow metabolic group,and the NO level was higher than that in the intermediate metabolic group and the slow metabolic group ( P<0.05). Conclusion Different genotypes of CYP2C19 have a certain effect on the therapeutic effect of clopidogrel in patients with cerebral infarction. Therefore,clinicians should carry out individualized treatment for different genotypes of CYP2C19 to improve its therapeutic effect.
万方数据
维普
