| BackgroundCoronary heart disease was rare in clinic and then has gradually increased insome countries before the twentieth Century20’s. At the end of the60’s, it had a peakand was serious harm to human health. With the development of economy and society,the level and way of human life had been improving and changing. Thecardiovascular disease has become one of the major diseases threatening humanhealth and coronary heart disease accounts for the largest proportion at present. Asearly as1969, World Health Organization released that coronary heart diseasebecomed one of the most common diseases. We can predict that the futuredevelopment trend that coronary heart disease will be the leading cause of death intwenty-first Century according to the epidemiological data available. The coronaryheart disease is developing in China at astonishing speed in recent years and the threatof death situation is grim.The percutaneous coronary intervention (PCI) has become the main method fortreatment of coronary heart disease and the number of patients with interventionaltherapy has a rapid growth in recent30years. At the same time, postoperativecomplications of PCI has received increasing attention. The stent thrombosis is one of the most serious complications after operation. After PCI Regular use of aspirinand clopidogrel which are antiplatelet aggregation drugs can reduce the occurrence ofcardiovascular ischemic events and improve the prognosis of patients with coronaryheart disease and Significantly reduce the incidence of stent thrombosis. However,because of the difference of response to clopidogrel resistance between individuals,4%-30%of patients do not reach the antiplatelet effect In the treatment of clopidogrelfor the performance of the clopidogrel showed no reactivity or low reaction. Thisphenomenon is called clopidogrel resistance. The incidence of stent thrombosisrelatively high risk and major adverse cardiovascular events in patients withclopidogrel resistance.Many factors can cause of lopidogrel resistance and the exact mechanism is notclear. According to the current study shows, genetic factors are the most importantfactor leading to clopidogrel resistance. CYP2C19gene belongs to the CYP450family of Isozymes and is involved in the metabolism of clopidogrel. The genepolymorphism is an important determinant of response to clopidogrel diversity.Therefore, it has been increasingly concerned about the CYP2C19’s gene diversity inclinical. It has an important significance to analysis and find the relationship betweenCYP2C19gene diversity and clopidogrel resistance in clinical.In this study, we analysis the relationship between CYP2C19genepolymorphism and clopidogrel resistance to accumulated data for the next step inorder to make better use of clopidogrel antiplatelet therapy.ObjectionWith the development oMethodscases of coronary heart disease patients as the research object. To give thesepatients300mg loading dose of clopidogrel,75mg maintenance dose, a week afterthe blood test Platelet response index (Platelet reactivity index, PRI), by TaqMantiming quantitative polymerase chain reaction (PCR) to detect and clopidogrel metabolism related CYP2C19*1,2,**,3, and metabolism of patients by CYP2C19carrying case can be divided into different types: strong metabolic type, intermediarymetabolism, metabolic type. Using analysis of variance PRI differences betweendifferent genotypes.ResultsCYP2C19*1,*2*3and the frequency of63.1%,30.3%and6.6%respectively.According to the metabolism of CYP2C19gene polymorphism loci functionclassification, carry CYP2C19*2or*3in the middle of the metabolic type (*1/*and*1/2*3) type and weak metabolism (*2*2*2/3*3*3and/*) accounted for43.7%,15.1%respectively. Gender differences on CYP2C19gene classification hasno statistical significance.ConclusionsIntervention in patients with coronary artery disease distribution more CYP2C19clopidogrel metabolism genes, missing of CYP2C19polymorphism can be used as animportant predictor of clopidogrel resistance. |
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