摘要
目的探讨CYP2C19基因多态性对中青年急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后主要不良心血管事件(MACE)的影响。方法将2018年3月至2019年1月于许昌市中心医院就诊的228例中青年ACS患者作为研究对象,月均行PCI。应用DNA微阵列芯片法测定CYP2C19基因类型,记录术后12个月内MACE的发生情况,依据MACE发生情况将患者分为两组,其中观察组62例,随访期间发生MACE;对照组166例,随访期间未发生MACE。对两组患者一般临床资料、实验室检查结果、CYP2C19基因分布进行分析。结果228例患者CYP2C19基因快代谢型(*1/*1)占42.1%,中间代谢型(*1/*2和*1/*3)占43.0%,慢代谢型(*2/*2、*2/*3和*3/*3)占14.9%。观察组快代谢型患者的例数及所占比例为19例(30.64%),低于对照组的77例(46.38%),差异有统计学意义(χ^(2)=4.588,P=0.032);观察组慢代谢型患者的例数及比例为15例(24.19%),高于对照组的19例(11.45%),差异有统计学意义(χ^(2)=5.781,P=0.016);二元Logistic回归分析显示,快代谢型患者MACE发生的可能是慢代谢型患者的31.7%(OR=0.317,95%CI:0.132~0.751,P=0.007),无糖尿病患者MACE发生的可能是有糖尿病患者的42.4%(OR=0.424,95%CI:0.213~0.882,P=0.019),无饮酒史的患者MACE发生的可能是有饮酒史患者的48.5%(OR=0.485,95%CI:0.211~0.907,P=0.009)。结论CYP2C19基因多态性对中青年ACS患者PCI后MACE会产生影响,快代谢型患者MACE发生的风险低于慢代谢型患者,PCI后患者需有效控制血糖,改变饮酒等不良生活习惯。
Objective To investigate the influence of CYP2C19 gene polymorphism on major adverse cardiovascular events(MACE)in young and middle-aged patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods ACS patients(n=228)were chosen from Central Hospital of Xuchang City from Mar.2018 to Jan.2019,and all patients received PCI.The genetic types of CYP2C19 were detected by using DNA microarray method,and incidence of MACE was recorded within 12 months after PCI.All patients were divided,according to MACE incidence,into observation group(had MACE during follow-up period,n=62)and control group(had no MACE during follow-up period,n=166).The general clinical materials,results of laboratory tests and CYP2C19 gene distribution were analyzed in 2 groups.Results In 228 patients,the patients with CYP2C19 gene fast metabolism type(*1/*1)accounted for 42.1%,those with intermediate metabolism type(*1/*2 and*1/*3)accounted for 43.0%,and those with slow metabolism type(*2/*2,*2/*3 and*3/*3)accounted for 14.9%.The cases of patients with*1/*1 were 19(30.64%)in observation group and 77(46.38%)in control group(χ^(2)=4.588,P=0.032).The cases of patients with*2/*2,*2/*3 and*3/*3 were 15(24.19%)in observation group and 19(11.45%)in control group(χ^(2)=5.781,P=0.016).The results of binary Logistic regression analysis showed that the possibility of MACE incidence in patients with*1/*1 was 31.7%of that in patients with*2/*2,*2/*3 and*3/*3(OR=0.317,95%CI:0.132~0.751,P=0.007).The possibility of MACE incidence in patients without diabetes was 42.4%of that in patients with diabetes(OR=0.424,95%CI:0.213~0.882,P=0.019).The possibility of MACE incidence in patients without drinking history was 48.5%of that in patients with drinking history(OR=0.485,95%CI:0.211~0.907,P=0.009).Conclusion CYP2C19;gene polymorphism has the influence on MACE in young and middle-aged patients with ACS after PCI.The risk of MACE is lower in patients with CYP2C19 fast metabolism type than that in patients with CYP2C19 slow metabolism type.ACS patients should effectively control blood sugar and change unhealthy habits including drinking after PCI.
作者
许宏磊
徐炳欣
鲁燕
赵艳
张云飞
郭树领
Xu Honglei;Xu Bingxin;Lu Yan;Zhao Yan;Zhang Yunfei;Guo Shuling(Department of Pharmacy,Central Hospital of Xuchang City,Xuchang 461000,China;不详)
出处
《中国循证心血管医学杂志》
2021年第6期672-675,691,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
河南省科技发展计划项目(182102310214)
许昌市重大科技专项(20180113031)。
