中国卒中杂志2016，Vol.11Issue(6)：455-461,7.DOI:10.3969/j.issn.1673-5765.2016.06.007
个体化抗血小板治疗对缺血性卒中二级预防的效果研究
The Study of Individualized Treatment of Antiplatelet in Secondary Prevention of Ischemic Stroke
摘要
Abstract
Objective To observe the therapeutic effect of individualized treatment of antiplatelet in secondary prevention of ischemic stroke. <br> Methods A prospective study was carried out in the 207 inpatients of ischemic stroke in Shanxi Provincial People’s Hospital from March, 2013 to May, 2014. The inpatients were randomly divided into individual treatment group and conventional treatment group which used 100 mg/d aspirin in antiplatelet treatment. The individual treatment group adopted Essen Stroke Risk Score (ESRS) and divided the patients into high risk group (treated with 75 mg/d clopidogrel) and low risk group (treated with 100 mg/d aspirin). The antiplatelet protocol was determined based on the result of thromboela stogram (TEG) and CYP2C19 genotype detection after the 7th day. They all were followed up for 1 year to observe their clinical end point events. <br> Results The platelet inhibition rate of clopidogrel was signiifcantly higher in inpatients of CYP2C19 fast metabolism genotype and medium metabolism genotype than that in poor metabolism genotype, which had signiifcant difference in outcome (P=0.018, P=0.015). The clinical end point event had no statistical signiifcance between individualized treatment group (112 cases) and conventional treatment group (n=95) (P>0.01). <br> Conclusion The platelet inhibition rate of application of clopidogrel of CYP2C19 fast metabolism genotype and medium metabolism genotype is obviously higher than that of CYP2C19 poor metabolism. The individualized treatment based on the CYP2C19 gene polymorphisms and TEG, compared the application of conventional treatment by aspirin, fails to reduce the incidence of end point events after ischemic stroke, which may require a larger scale and longer follow-up period study.关键词
CYP2C19/血栓弹力图/阿司匹林/氯吡格雷/缺血性卒中Key words
CYP2C19/Thrombelastography/Aspirin/Clopidogrel/Ischemic stroke引用本文复制引用
刘玥,李晓青,侯辰,唐鹏,陈丽,张欣,种莉,刘鹏,李锐,赵性泉..个体化抗血小板治疗对缺血性卒中二级预防的效果研究[J].中国卒中杂志,2016,11(6):455-461,7.基金项目
立项文号陕科计发【2015】76号项目类别社会发展科技攻关-社会发展科技攻关项目项目编号12015SF023项目名称缺血性脑血管病介入治疗中氯吡格雷抵抗干预策略研究承担单位陕西省人民医院 （）
