陕西医学杂志2024，Vol.53Issue(10)：1402-1406,5.DOI:10.3969/j.issn.1000-7377.2024.10.023
CYP2C19基因型检测对急性心肌梗死经皮冠状动脉介入术后抗血小板药物治疗的临床研究
Clinical study of CYP2C19 genotype detection for antiplatelet therapy after PCI in patients with acute myocardial infarction
摘要
Abstract
Objective:To analyze the value of CYP2C19 genotype detection in guiding drug treatment after per-cutaneous coronary intervention(PCI)in acute myocardial infarction(AMI).Methods:A total of 86 patients with AMI were prospectively selected and divided into observation group and control group by random number table meth-od.Both groups were treated with PCI,and the treatment was carried out routinely according to the guidelines after operation.The CYP2C19 genotype distribution of the patients in the observation group was detected 72 hours after operation and the medication was guided.If the genetic test results showed that the patients were clopidogrel slow metabolism or medium metabolism type,clopidogrel should be discontinued and switched to ticagrelor treatment.The genetic test results showed that the patients with clopidogrel fast metabolism type were still treated with clopi-dogrel.The control group did not detect gene distribution for clopidogrel routine treatment.The efficacy of the two groups was evaluated after 3 months of treatment.The levels of myocardial markers(cTnI CK-MB)were measured before treatment and 3 months after treatment in the two groups.The platelet aggregation rate of the two groups be-fore treatment and at the end of follow-up(12 months of treatment)was detected,and the adverse cardiovascular events(MACE)and bleeding events were recorded.Results:After 3 months of treatment,the overall effect of observation group was better than that of control group(P＜0.05);cTnI and CK-MB in observation group were lower than those in control group(all P＜0.05).At the end of follow-up,the platelet aggregation rate,MACE and bleeding event incidence in observa-tion group were lower than those in control group(all P＜0.05).Conclusion:The distribution of CYP2C19 genotype in pa-tients with AMI after PCI can guide antiplatelet therapy,which can improve the overall therapeutic effect,have a good effect on myocardial function and platelet aggregation rate,and reduce the occurrence of adverse events and bleeding events.关键词
急性心肌梗死/经皮冠状动脉介入/CYP2C19基因/抗血小板/氯吡格雷/替格瑞洛Key words
Acute myocardial infarction/Percutaneous coronary intervention/CYP2C19 gene/Antiplatelet/Clopidogrel/Ticagrelor分类
医药卫生引用本文复制引用
王敏,裴蕊慧,向宗兴..CYP2C19基因型检测对急性心肌梗死经皮冠状动脉介入术后抗血小板药物治疗的临床研究[J].陕西医学杂志,2024,53(10):1402-1406,5.基金项目
陕西省中医药管理局中医药科研项目(2019-GJ-LC022) （2019-GJ-LC022）
