CYP2C19 Gene Polymorphism in Patients with Ischemic Cerebrovascular
|School||Taishan Medical College|
|Keywords||CYP2C19 site gene polymorphism platelet aggregation rate|
ObjectiveTo observe CYP2C19 gene polymorphism,and explore the ralationship between CYP2C19 gene polymorphism and ischemic cerebrovascular events.MethodSelect 106 patients with ischemic cerebrovascular disease in Department of Neurology, the Second Artillery General Hospital from December 2009 to June 2010 Department.57cases of male, female 49,Range of clopidogrel 75mg / d. The number of patients of cerebral infaction is 72,and 34 with non-infarction according to diagnostic criteria for cerebral infarction.Patients with cerebral infarction as class A patients;Patients who was infarction in the first time as class A1,of which 49 patients ,21 were male and 28 femal;Patients who infarcted for twice and more as class A2,of which 14 were male,9 femal.The average age of class A was 73.72±12.07.patients who was found no abnormalities by imaging examinations as class B,the number was 34,male was 22,and 12 were female,average age was 73.24±14.50.Collect the patients 2ml Peripheral blood, applied CYP2C19 genotypes by the PCR-RFLP assay for those patients were AA/AG/GG. We divided the into two groups in another way according to clinical events ,that was:patients who were still infarction or multiple infarction,as infarct group.Patients have not occurred infarction patient,as the control group.The results of the two experimental groups were analsised by SPSS17.0 software.Result(1)Demographic study information: The two groups according to clinical events had no significant difference (P> 0.05) between age, etc.(2)Genotyping analysis showed that: All enrolled patients were genotype occurred AA/AG/GG: 13.2%/35.8%/51%,14/38/54people respectively.A mutation in one allele was 31.1%. the three genotypes AA/AG/GG proportion Infarction was respectively AA12(16.7%)/AG36(50%)/GG24(33.3%). Of which A allele mutation rate was 43.8%. The number of patients with different genotype in the A1 class were AA type 5 (35.7%) / AG type 24 (63.15%) / GG type 20 (37.0%),in the A2 class were AA type7 (50%) / AG type 12 (31.6%) / GG type 4 (7.4%).in the B class were AA type 2 (5.9%) /AG type2 (5.9%)/GG type 30 (88.2%) percent. A allele mutation rate was 7.7%.AA-GG,AG-GG genotype compared with recurrent vascular events in gene-positive rate.have different significant (P﹤0.05).(3) The three groups by patients grouped according to genotype Genotypes AA / AG / GG patients the average rate of platelet aggregation were 73.9±9.45%,69.36±3.96%,68.23±8.07%. AA / AG / GG the number of infarction people of each group’s share of total infarction were AA (85.7%) / AG (95%) / GG (44.4%). Comparison with the GG genotype AA-positive rate, and the AG type and GG genotype significantly was different between the positive rate (P <0.05), that AA-and AG genotype patients occurred infarction more easiely than GG genotype.Conclusion(1)The probability of occurrence of infarction of Patients who carriers Cytochrome P450 CYP2C19 A allele was more than wild-type GG genotype after taking clopidogrel on platelet aggregation.(2)Patients taking clopidogrel who were P450 CYP2C19 AA-type allele ,the average platelet aggregation rate were higher than the type GG and AG patients, but there was no significant difference.(3)The population mutation rate of the A allele was 43.8% in the Infarction group. of all study population was 31.1% .They have significant difference (χ2 =5.909, P <0.05). AA-ratio in patients with recurrent cerebral infarction compared with GG-type has significant difference (χ2=15.275,P﹤0.05). It tolds us patients who carriy alleles A was more prone to infarction in study.Maybe the gene mutation lead to clopidogrel resistance.