目的 探讨黑龙江地区脑梗死患者接受氯吡格雷治疗时CYP2C19 基因多态性对治疗效果的影响。方法 选取 2022 年1-12 月在黑龙江省医院神经内科住院的 90 例脑梗死患者为研究对象。检测CYP2C19 基因多态性，根据检测结果，将患者分为 3 组，快代谢组(n=26)、中等代谢组(n=52)和慢代谢组(n=12)。所有患者均给予氯吡格雷治疗，对美国国立卫生研究院卒中量表(National Institute of Health stroke scale，NIHSS)评分及预后情况进行观察对比。结果 在脑梗死患者中以快代谢型和中等代谢型为主要类型。治疗 2 周后，3 组NIHSS评分低于治疗前，差异有统计学意义(P＜0。05);且快代谢组评分为(6。23±1。38)分，低于中等代谢组、慢代谢组的(7。76±1。71)分、(10。12±1。29)分，差异有统计学意义(P＜0。05);快代谢组和中等代谢组预后良好率高于慢代谢组(P＜0。05);快代谢组、中等代谢组和慢代谢组不良反应总发生率比较，差异无统计学意义(P＞0。05)。结论 通过对老年脑梗死患者行CYP2C19 基因型检测来评估对氯吡格雷治疗的药物代谢能力和反应情况。有助于制定个体化的治疗方案，提高治疗效果并降低不良反应的发生率，可以最大限度地提高治疗效果，减少风险发生。
The Effect of CYP2C19 Gene Polymorphism on the Efficacy of Clopidogrel in Elderly Patients With Cerebral Infarction in Heilongjiang Region
Objective To investigate the impact of CYP2C19 gene polymorphism on the treatment effect of clopidogrel in patients with cerebral infarction in Heilongjiang region.Methods A total of 90 patients with cerebral infarction who were hospitalized in the department of neurology,Heilongjiang Provincial Hospital from January to December 2022 were selected as the study objects.The polymorphism of CYP2C19 gene was detected.According to the detection results,the patients were divided into 3 groups,fast metabolism group(n=26),medium metabolism group(n=52)and slow metabolism group(n=12).All patients were treated with clopidogrel,and the National Institute of Health stroke scale(NIHSS)score and prognosis were observed and compared.Results In patients with cerebral infarction,the main types were fast metabolic type and medium metabolic type.After 2 weeks of treatment,the NIHSS score of 3 groups was lower than before treatment,and the difference was statistically significant(P<0.05).The score of fast metabolism group was(6.23±1.38)points,which was lower than(7.76±1.71)points and(10.12±1.29)points of medium metabolism group and slow metabolism group,and the difference was statistically significant(P<0.05).The rates of good prognosis in fast metabolism group and medium metabolism group were higher than those in slow metabolism group(P<0.05).There was no significant difference in the total incidence of adverse reactions between fast metabolism group,medium metabolism group and slow metabolism group(P>0.05).Conclusion This study evaluated the drug metabolism and response to clopidogrel treatment by conducting CYP2C19 genotype testing in elderly patients with cerebral infarction,which helps to develop personalized treatment plans,improve treatment effectiveness,and reduce the incidence of adverse reactions,which can maximize treatment effectiveness and reduce risk occurrence.
万方数据
维普
