保健医学研究与实践2025，Vol.22Issue(10)：75-81,7.DOI:10.11986/j.issn.1673-873X.2025.10.12
PCI术后冠心病患者经氯吡格雷治疗后发生MACE与CYP2C19基因多态性的关系研究
Relationship between MACE occurrence and CYP2C19 gene polymorphism in patients with coronary heart disease after PCI treatment with clopidogrel
摘要
Abstract
Objective To explore the relationship between the occurrence of major adverse cardiovascular events(MACE)after clopidogrel treatment in patients with coronary heart disease(CHD)following percutaneous coronary intervention(PCI)and the cytochrome P450 2C19(CYP2C19)gene polymorphism,aiming to provide a reference for clinical treatment.Methods This study included 111 patients with CHD who underwent PCI and were treated with clopidogrel and aspirin for 6 months af-ter surgery,admitted to the 901st Hospital of the Joint Logistics Support Force of the People's Liberation Army between Janu-ary 2022 and June 2024.Based on whether MACE occurred within 6 months of treatment,the patients were assigned to the MACE group(n=23)and the non-MACE group(n=88).General data were collected on the first day on admission,including sex,age,cardiac function classification,number of coronary artery stents,and left ventricular ejection fraction.CYP2C19 gen-otyping was determined using polymerase chain reaction(PCR).Multivariate logistic regression analysis was conducted to i-dentify factors influencing MACE occurrence after clopidogrel treatment in CHD patients.Results Among the CHD patients,37(33.33%)had the fast metabolizer CYP2C19 genotype,63(56.76%)had the intermediate metabolizer genotype,and 11(9.91%)had the slow metabolizer genotype.The distribution of CYP2C19 genotypes and metabolic phenotypes between the MACE and non-MACE groups showed statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that the CYP2C19 *2/*2 genotype(OR=5.573,95%CI:1.593-19.500),CYP2C19 *2/*3 genotype(OR=1.774,95%CI:1.051-2.993),and CYP2C19 slow metabolizer phenotype(OR=4.889,95%CI:2.386-10.018)were in-dependent risk factors for MACE occurrence after clopidogrel treatment(P<0.05).Conclusion CYP2C19 gene polymor-phism is closely correlated with the occurrence of MACE in CHD patients treated with clopidogrel.Slow metabolizers are more prone to clopidogrel resistance and have a higher risk of MACE occurrence.Clinically,the use of clopidogrel should be avoided in these patients.关键词
冠心病/氯吡格雷/CYP2C19/不良心血管事件/基因多态性Key words
Coronary heart disease/Clopidogrel/CYP2C19/Major adverse cardiovascular events/Gene polymorphism分类
医药卫生引用本文复制引用
Wang Jing,Li Binbin,Xu Min,Zhang Yumei,Zhou Dan,He Wei,Zha Guizhen,Liu Xuechun..PCI术后冠心病患者经氯吡格雷治疗后发生MACE与CYP2C19基因多态性的关系研究[J].保健医学研究与实践,2025,22(10):75-81,7.基金项目
安徽省重点研究与开发计划项目(2022e07020029). （2022e07020029）
