中国中西医结合杂志2017，Vol.37Issue(3)：291-296,6.DOI:10.7661/CJIM.2017.03.0291
229例急性冠脉综合征氯吡格雷抵抗患者CYP2C19基因多态性与中医证型分布的相关性
Correlation between CYP2C19 Gene Polymorphism with Clopidogrel Resistance and Distribution of Chinese Medicine Syndrome in 229 Acute Coronary Syndrome Patients
摘要
Abstract
Objective To observe correlation between CYP2C19*2/CYP2C19*3 gene polymorphism with clopidogrel resistance and distribution of Chinese medicine (CM) syndrome in acute coronary syndrome (ACS) population.Methods Peripheral blood was collected from 229 ACS patients from June 2014 to March 2015.DNAs were extracted,amplified,and sequenced.Correlations between CYP2C19 * 2/CYP2C19 * 3 gene polymorphisms and clopidogrel resistance/distribution of CM syndrome were analyzed.Gene frequency and allele frequency were tested using gene counting and one-sample K-S test.Correlation between gene types and distribution of CM syndrome was tested by Pearson correlation test.Results (1) The CYP2C19*2 polymorphism distribution:CYP2C19 *2(A/A) (mutant homozygous) 12 cases (5.2％);CYP2C19 *2 (G/A) (mutant heterozygote) 93 cases (40.6％),and CYP2C19 * 2 (G/G) (normal homozygous) 124 cases (54.2％).The mutant allele frequency was 0.255.(2) The CYP2C19 *3 polymorphism distribution:CYP2C19 *3 (A/A) 0 case (0);CYP2C19*3 (G/A) 26 cases (11.4％),and CYP2C19 * 3 (G/G) 203 cases (88.6％).The mutant allele frequency was 0.056.(3) Correlation between CYP2C19 gene polymorphism and clopidogrel resistance.Clopidogrel resistance was more liable to occur in mutant homozygous than in mutant heterozygote and normal homozygous (R =0.30,P ＜0.01).Clopidogrel resistance was more liable to occur in mutant heterozygote than in normal homozygous (R =0.34,P ＜0.01).(4) Among the 229 patients,the CM syndrome distribution were distributed as follows.Blockage of Xin vessels syndrome (BXVS,33 cases,14.41％);qi deficiency blood stasis syndrome (QDBSS,51 cases,22.27％);qi stagnation blood stasis syndrome (QSBSS,92 cases,40.18％);phlegm obstructing Xin vessel syndrome (POXVS,17 cases,7.42％);yin-cold coagulation syndrome (YCCS,8 cases,3.49％);qi-yin deficiency syndrome (QYDS,13 cases,5.68％);Xin-Shen yin deficiency syndrome (XSYDS,5 cases,2.18％),yang and qi deficiency syndrome (YQDS,10 cases,4.37％).(5) CYP2C19 *2 gene type was significantly correlated with syndrome typing of CM (R =0.26,P ＜0.01).Mutant homozygous and most mutant heterozygote patients were syndrome typed as QDBSS.Conclusions The polymorphism of CYP2C19 was closely correlated with clopidogrel resistance in 229 ACS patients.Its occurrence rate was correlated with CYP2C19 * 2/CYP2C19 * 3 gene mutation frequency.Blood stasis syndrome (QSBSS,QDBSS,BXVS) were main syndromes of ACS.Besides,QSBSS was obviously higher than the rest syndrome types.The polymorphism of CYP2C19 * 2was correlated with syndrome typing of CM.CYP2C19 *2 gene defect mostly existed in QSBSS.关键词
CYP2C19基因多态性/中医证型分布/氯吡格雷抵抗/急性冠脉综合征Key words
CYP2C19 polymorphism/Chinese medicine syndrome distribution/clopidogrel resistance/acute coronary syndrome引用本文复制引用
沈智杰,陈骁康,王英杰,郭蔚,陈铁军,王肖龙..229例急性冠脉综合征氯吡格雷抵抗患者CYP2C19基因多态性与中医证型分布的相关性[J].中国中西医结合杂志,2017,37(3):291-296,6.基金项目
国家自然科学基金资助项目(No.81573647,No.81403137) （No.81573647,No.81403137）
上海市科委“科技创新行动计划”资助项目(No.14401972202) （No.14401972202）
上海市科委项目(No.13ZR1462100) （No.13ZR1462100）
