Relevant Analysis Of CYP2C19 In Cerebral Infarction Patients With Intracranial Vascular Stenosis

Objective:To study the incidence,distribution and possible relevant influence factors of CYP2C19 in cerebral infarction patients with intracranial vascular stenosis.Methods:Collected 55 cases of hospitalized patients from March,2018 to December 2018,who had to be hospitalized in the First Bethune hospital of Jilin university,because of the acute cerebral infarction,and related examination revealed their intracranial vascular stenosis.According to their clinical symptoms and signs,combining with head MRI,TCD,CA,CYP2C19 gene detection and other auxiliary examinations dates were analyzed retrospectively,to explore the incidence,distribution and possible influence factors of CYP2C19 in cerebral infarction patients with intracranial vascular stenosis.Results:(1)Among 55 patients of this research,the youngest was 38 years old,the oldest was 85 years old,mean age 62.69 years old,the peak incidence of age mainly concentrated in the age between 56 ~ 65(36.36%).The main genetic types was* 1 / * 2 in patients who were under the age of 55(61.54%)and the age between 66~75(41.67%),and the main genetic types of the age at 56~65 and 76~85 were * 1 / * 1,accounting for 55.00% and 70.00% of their group respectively.The results of statistical analysis showed that age was relatively independent from the distribution of genotypes of CYP2C19(Fisher's exact test value=18.878,P=0.065>0.05).(2)There were 38 male patients(69.09%)and17 female patients(30.91%)in this group.*1/*1(47.37%)was the most common genotype in male patients,while *1/*2(47.06%)was the most common genotype in female patients.There was no statistical significance between gender and genotype distribution of this gene(P>0.05).(3)A total of six gene types were detected,including *1/*1(41.82%)? *1/*2(40.00%)? *1*3(3.64%)?*2/*2(7.27%)? *2/*3(5.45%)and *3/*3(1.82%).There were 23 cases of fast metabolism(41.82%),24 cases of intermediate metabolism(43.64%),and 8 cases of slow metabolism(14.55%).(4)The risk factors of cerebrovascular diseases were detected,and there were 44 cases(80.00%)of patients with hypertension,20 cases(36.36%)of patients with diabetes,11 cases(20.00%)of patients with coronary heart disease,30 cases(54.55%)of patients with hyperlipidemia,7 cases(12.73%)of patients with hyperhomocysteinemia,and 27 cases(49.09%)of patients with smoking.*1/*1 was the most common gene type in patients with hypertension(45.45%),hyperlipidemia(46.67%),hyperhomocysteinemia(44.44%)and smoking(85.71%).*1/*2 was the most common gene type in patients with coronary heart disease(45.45%)and diabetes(45.00%).The results showed that the risk factors of cerebrovascular disease were relatively independent of the distribution of genotypes(P>0.05).(4)20cases(36.36%)of simple anterior circulation cerebral infarction,18 cases(32.73%)of simple posterior circulation cerebral infarction,and 17 cases(30.91%)of the whole circulation cerebral infarction.*1/*1(45.00%)was the most common genotype in patients with simple anterior circulation cerebral infarction.*1/*1(38.89%)and *1/*2(38.89%)were more common in patients with simple posterior circulation cerebral infarction,and *1/*1 and *1/*2(both 41.18%)were more common in patients with whole circulation cerebral infarction.There were 23 cases(41.82%)of anterior circulation stenosis,16 cases(29.09%)of posterior circulation stenosis,and 16 cases(29.09%)of whole circulation stenosis.*1/*1 and *1/*2 were more common genotypes in patients with different stenosis sites.There were 27 cases(49.09%)of single vascular stenosis stenosis,28 cases(50.91%)of multi-vessel stenosis.*1/*2(51.85%)was the main genotype of patients with single vascular stenosis,and *1/*1(50.00%)was more common in patients with multi-vessel stenosis.Statistical analysis showed that the location of cerebral infarction,the site of intracranial vascular stenosis,the number of vascular stenosis and the distribution of genotypes were relatively independent(P>0.05).Conclusion:In patients with cerebral infarction complicated with intracranial vascular stenosis,the incidence of CYP2C19 genotype and metabolic type was basically consistent with the general population.The most common risk factors of cerebrovascular disease in patients with cerebral infarction complicated with intracranial vascular stenosis are hypertension and hyperlipidemia.The distribution of CYP2C19 genotype have nothing to do with hypertension,hyperlipidemia and other risk factors.The distribution of CYP2C19 genotype was relatively independent of the location of cerebral infarction,the site of intracranial vascular stenosis,and the number of intracranial vascular stenosis.