Clinical Study On TCM Constitution Types And Clopidogrel-related CYP2C19 Gene Polymorphism In Acute Cerebral Infarction

ObjectiveTo observe the distribution of Traditional Chinese Medicine(TCM)Constitution Types and the distribution of clopidogrel-related CYP2C19 Gene Polymorphism.To investigate the correlation between TCM Constitution classification and clopidogrelrelated CYP2C19 Gene Polymorphism in acute cerebral infarction.MethodsA cross-sectional survey method was used in this study.Patients with acute cerebral infarction were screened according to our inclusion and exclusion criteria.General information of included patients were collected,and Traditional Chinese Medicine Constitution were evaluated according to the questionnaire survey with TCM constitution table “Classification and Judgment Table of Traditional Chinese Medicine Constitution”.Genotypes of CYP2C19 was determined by Digital Fluorescence Hybridization Technology.Hardy-Weinberg's Equilibrium was used to examine whether CYP2C19 Gene Polymorphism of the patients is balanced.Measurement data subjected to normal distribution was shown in ?x±s,and two independent samples t test was used for statistical analysis;while non-normal data was shown in median and interquartile,and Wilcoxon Mann-Whitney U test was used;count data was shown in constituent ratio,and Chi-Square Test,or Correction Chi-Square Test,orFisher's exact probability was used.Binary logistic regression analysis was used to explore the relationship between TCM Constitution types and clopidogrel-related CYP2C19 Gene Polymorphism in acute cerebral infarction.Results1.From July 2017 to January 2019,a total of one hundred acute cerebral infarction patients were included in our study,and the average of included patients was68.49±10.77.Of which,66 cases was males and 34 females.2.Genotype and allele tests of CYP2C19*2 and CYP2C19*3 were in accordance with Hardy-Weinberg's Equilibrium examines(P>0.05).3.The CYP2C19*2 Gene Polymorphism distribution: CYP2C19*2(A/A)(mutant homozygous)21 cases(21%),CYP2C19*2(A/G)(mutant heterozygote)33 cases(33%),CYP2C19*2(G/G)(normal homozygous)46 cases(46%).The mutant allele frequency was 0.375.4.The CYP2C19*3 Gene Polymorphism distribution: CYP2C19*3(A/A)1 cases(1%),CYP2C19*3(G/A)14 cases(14%),CYP2C19*3(G/G)85 cases(85%).The mutant allele frequency was 0.08.5.The Traditional Chinese Medicine Constitution distribution: Yang-deficiency constitution(18 cases,18%),Yin-deficiency constitution(30 cases,30%),Qi-deficiency constitution(18 cases,18%),Phlegm-dampness constitution(51 cases,51%),Damp-heat constitution(14 cases,14%),Special constitution(2 cases,2%),Blood-stasis constitution(27 cases,27%),Qi stagnation constitution(4 cases,4%),Normal constitution(11 cases,11%).And one-only constitution(41 cases,41%),two-intergrated constitution(46 cases,46%),three-intergrated constitution(10 cases,10%),four-intergrated constitution(3 cases,3%).6.Binary logistic regression analysis: compared with A/A genotype,G/G genotype of CYP2C19*2 in acute cerebral infarction was correlated with phlegm-dampness constitution(OR=5.105,95%CI:1.308-19.928,P<0.05)andblood-stasis constitution(OR=12.557,95%CI:1.741-90.558,P<0.05).Conclusion1.The proportion of phlegm-dampness constitution is the highest in patients with acute cerebral infarction,and the combination of more than two constitutions is common.2.The mutation rate of clopidogrel-related CYP2C19*2 was significantly higher than that of CYP2C19*3.3.Clopidogrel-related CYP2C19*2 Gene Polymorphism might be related to Phlegm-dampness constitution and Blood-stasis constitution.