Research On The Relationship Between CYP2C19 Gene Polymorphism And Acute Ischemic Cerebral Vascular Disease

Object To investigate the correlation of the gene polymorphisms of CYP2C19 between patients with TIA who suffered cerebral infarction in 90 days and whose who did not suffer in 90 days;to investigate the correlation of the gene polymorphisms of CYP2C19 between patients who had progression of acute cerebral infraction within one week and those who did not.Methods The research was conducted on 118 patients with TIA and 179 patients with acute cerebral infraction who were hospitalized in the emergency department and neurology department of Zaozhuang Municipal Hospital between November,2015 and September,2016.The patients with TIA were divided into cerebral infarction group and non-cerebral infection group according to whether there was cerebral infarction within 90 days.179 patients with acute cerebral infarction were divided into progression group and non-progression group according to whether there was progression within one week.On the first day in hospital,all the patients were treated with aspirin and clopidogrel.On the second day,the blood test was taken on an empty stomach to check the blood glucose,blood lipid,liver and kidney function.Blood routine examination and blood coagulation were taken as well.With 5ml blood sample taken from each patient on an empty stomach,the CYP2C19 genotypes in each group were detected by fluorescence staining and in situ hybridization.The measurement data was described in the form of mean plus and minus standard deviations(x �S),the comparison between the two groups used t test;proportion or prevalence was computed for count data;the differences between groups were compared with c2 test.Both sides tests were used for comparison between groups and the significance level was set 0.05(P < 0.05).Logistic regression models were analyzed to reveal the risk factors for cerebral infraction resulting from TIA and progression of acute cerebral infraction,and the significance level was set 0.05(P<0.05).Result 28 patients with TIA suffered from cerebral infarction in 90 days and the other 90 cases did not.There were no statistically significant differences in age,gender,blood pressure,blood glucose,and blood lipid between patients of the two groups(P>0.05).The number of EM patients in cerebral infraction groups(21.4%)was lower than that of non-cerebral infraction groups(56.7%)(P < 0.01)while the number of PM patients in cerebral infraction groups(25.7%)was higher than that of non-cerebral infraction groups(10%)(P < 0.01).There was no significant difference of IM patients(P >0.05).For the 179 patients with acute cerebral infraction,there were 44 cases of progression and135 cases of non-progression within one week.There were no statistically significant differences in age,gender,blood pressure,blood glucose,and blood lipid between patients of the two groups(P>0.05).There were fewer EM patients in progression group(29.5%)than in non-progression group(60%)(P < 0.01).There were more PM patients in progression group(25%)than in non-progression group(6.7%)(P < 0.01).There was no significant difference in IM patients(P > 0.05).Multivariate logistic regression analysis showed that CYP2C19 gene polymorphisms were independently related to cerebral infarction resulting from TIA and the progression of acute cerebral infraction.Conclusion There was lower risk of cerebral infarction resulting from TIA for patients with EM type of CYP2C19 gene.Patients with PM type of CYP2C19 gene were more likely to suffer from cerebral infraction.Acute cerebral infraction is more likely to progress in patients with PM type of CYP2C19 than in patients with EM type of CYP2C19.CYP2C19 gene polymorphisms were independent risk factors for TIA cerebral infraction and progression of acute cerebral infraction.Significance With the progress of science and technology as well as the development of precision medicine,gene testing has been used more frequently in clinical medicine.In recent years,the research of gene polymorphisms of CYP2C19 went further meanwhile more attention was focused on the correlation between gene polymorphisms of CYP2C19 and the etiology and risk stratification of ischemic cardiovascular and cerebrovascular diseases.Recent studies have shown that the mutation in CYP2C19 is an independent risk factor for coronary heart disease.This thesis studies the correlation between the gene polymorphisms of CYP2C19 and cerebral infarction resulting from transient ischemic attack(TIA)as well as the impact of the gene polymorphisms of CYP2C19 on the progression of acute cerebral infraction.According to the result,the gene polymorphisms of CYP2C19 is an independent risk factor for the cerebral infarction resulting from TIA and the progression of acute cerebral infarction.The study has instructive significance for the treatment,the prognosis and the prevention of such diseases.