本文選題：CYP2C19　切入點：基因多態(tài)性　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究TIA患者90天內(nèi)發(fā)生腦梗死與未發(fā)生腦梗死患者之間CYP2C19基因多態(tài)性的關(guān)系以及急性腦梗死患者1周內(nèi)腦梗死進展與腦梗死未進展患者之間的CYP2C19基因多態(tài)性的關(guān)系。方法:選取2015.11-2016.9之間在棗莊市立醫(yī)院急診科與神經(jīng)內(nèi)科住院的TIA患者118例,按照90天內(nèi)是否發(fā)生腦梗死分為發(fā)生腦梗死組和未發(fā)生腦梗死組,同期的急性腦梗死患者179例,按照1周內(nèi)是否進展分為腦梗死進展組和腦梗死未進展組。所有患者入院后予阿司匹林及氯吡格雷聯(lián)合聯(lián)合抗血小板治療,入院第二天抽空腹血查血糖、血脂、肝腎功能、血常規(guī)及凝血檢查,并抽空腹血5ml應(yīng)用熒光染色原位雜交測序檢測法檢測各組患者的CYP2C19基因型。計量資料用均數(shù)加減標準差(x±S)形式表示,并進行t檢驗,計數(shù)資料采用率和構(gòu)成比,組間比較采用c2檢驗;如果兩組數(shù)據(jù)比較P0.05,則認為兩組對比數(shù)據(jù)之間的差異有顯著統(tǒng)計學(xué)意義。采用Logistic回歸分析TIA發(fā)生腦梗死的危險因素及急性腦梗死進展的危險因素P0.05為有顯著統(tǒng)計學(xué)意義。結(jié)果:TIA患者90天內(nèi)發(fā)生腦梗死28例,未發(fā)生腦梗死90例。兩組患者在年齡、性別、血壓、血糖、血脂等方面的差異均無統(tǒng)計學(xué)意義(P0.05)。發(fā)生腦梗死組EM型患者(21.4%)顯著低于未發(fā)生腦梗死組(56.7%)(P0.01),而發(fā)生腦梗死組PM型患者(35.7%)顯著高于未發(fā)生腦梗死組(10%)(P0.01)。IM型患者兩者間無明顯差異(P0.05)。急性腦梗死1周內(nèi)進展患者44例,腦梗死未進展患者135例。兩組患者在年齡、性別、血壓、血糖、血脂等方面的差異均無統(tǒng)計學(xué)意義(P0.05)。腦梗死進展組EM型患者(29.5%)顯著低于未發(fā)生腦梗死組(60%)(P0.01),腦梗死進展組PM型患者(25%)顯著高于未發(fā)生腦梗死組(6.7%)(P0.01),IM型患者兩者間無明顯差異(P0.05)。Logistic回歸分析顯示,CYP2C19基因多態(tài)性與TIA發(fā)生腦梗死和急性腦梗死進展獨立相關(guān)。結(jié)論:CYP2C19基因EM型的TIA患者90內(nèi)不易發(fā)生腦梗死,PM型患者容易發(fā)生腦梗死;急性腦梗死患者CYP2C19基因PM型容易發(fā)生進展,而EM型患者不易發(fā)生進展。CYP2C19基因多態(tài)性是TIA發(fā)生腦梗死和急性腦梗死進展的獨立危險因素。意義:隨著科技進步及精準醫(yī)學(xué)的發(fā)展,基因檢測在臨床醫(yī)學(xué)中的應(yīng)用越來越多。近年來對CYP2C19基因的研究越來越深入,越來越多的人把焦點集中到CYP2C19基因多態(tài)性與缺血性心腦血管疾病的發(fā)病原因和危險分層上來。最近有研究發(fā)現(xiàn)攜帶CYP2C19突變基因是冠心病發(fā)病的一個獨立危險因素,本文研究了CYP2C19基因多態(tài)性與TIA發(fā)生腦梗死及急性腦梗死進展之間的關(guān)系,發(fā)現(xiàn)CYP2C19基因多態(tài)性是TIA發(fā)生腦梗死和急性腦梗死進展的獨立危險因素,對于疾病的治療、預(yù)后的判斷及預(yù)防有著重要的指導(dǎo)意義。
[Abstract]:Objective: to study the relationship between the polymorphism of CYP2C19 gene in patients with cerebral infarction and those without cerebral infarction within 90 days in patients with TIA and the polymorphism of CYP2C19 gene between patients with acute cerebral infarction and patients with cerebral infarction within one week. Methods: a total of 118 patients with TIA were enrolled in emergency department and neurology department of Zaozhuang Municipal Hospital between May and June 2016.Methods: a total of 118 TIA patients were enrolled in this study. According to whether or not cerebral infarction occurred within 90 days, there were 179 patients with acute cerebral infarction in the same period. All patients were treated with aspirin and clopidogrel combined with antiplatelet therapy after admission. Blood glucose, blood lipids, liver and kidney function were measured on the second day of admission. The CYP2C19 genotypes of patients in each group were detected by fluorescence staining in situ hybridization sequencing and 5ml of abdominal blood was detected by blood routine examination and coagulation examination. The measured data were expressed in the form of mean plus or minus standard deviation (x 鹵S), and t test was performed. The rate and composition ratio of counting data were used, and c2 test was used for the comparison between groups. If the two groups were compared with P0.05, the difference between the two groups was statistically significant. Logistic regression analysis was used to analyze the risk factors of cerebral infarction in TIA and the risk factors of progression of acute cerebral infarction (P0.05). Results 28 cases of cerebral infarction occurred within 90 days in patients with TIA. No cerebral infarction occurred in 90 cases. Two groups of patients in age, sex, blood pressure, blood sugar, There was no significant difference in serum lipids and blood lipids in patients with acute cerebral infarction (P 0.05). The levels of serum lipid in EM patients with cerebral infarction were significantly lower than those in patients with no cerebral infarction (56.7% P 0.01), while those in PM type patients with cerebral infarction were 35.7m) significantly higher than those in patients without cerebral infarction (P 0.01.IM). 44 patients with acute cerebral infarction developed within one week. 135 patients with no progress of cerebral infarction. Two groups of patients in age, sex, blood pressure, blood sugar, There was no significant difference in serum lipids and blood lipids (P 0.05). There was no significant difference in serum lipids between patients with EM type and without cerebral infarction group (P 0.01) and PM type PM group with cerebral infarction progression group (P < 0.05), which was significantly higher than that with no cerebral infarction group with P 0.01IM type and without cerebral infarction group (P < 0.01). Logistic regression analysis showed that the polymorphism of CYP2C19 gene was independently correlated with the progression of cerebral infarction and acute cerebral infarction in TIA. Conclusion the PM type of cerebral infarction is not easy to occur in TIA patients with EM type of CYP2C19 gene within 90 years. In patients with acute cerebral infarction, the PM type of CYP2C19 gene is prone to progress, while the polymorphism of CYP2C19 gene is an independent risk factor for the progression of cerebral infarction and acute cerebral infarction in patients with acute cerebral infarction (ACI), while the polymorphism of CYP2C19 gene is an independent risk factor for the progression of cerebral infarction and acute cerebral infarction in patients with acute cerebral infarction. The application of gene detection in clinical medicine is more and more. In recent years, the research on CYP2C19 gene is more and more in-depth. More and more people are focusing on the relationship between CYP2C19 gene polymorphism and the pathogenesis and risk of ischemic cardiovascular and cerebrovascular diseases. Recently, it has been found that carrying the CYP2C19 mutation gene is an independent risk factor for coronary heart disease. The relationship between the polymorphism of CYP2C19 gene and the progression of cerebral infarction and acute cerebral infarction in TIA was studied. It was found that the polymorphism of CYP2C19 gene was an independent risk factor for the progression of cerebral infarction and acute cerebral infarction in TIA. The judgment and prevention of prognosis have important guiding significance.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

【參考文獻】

相關(guān)期刊論文 前10條

1 劉麗霞;薛劍;張孝忠;陳建魁;張軍軍;;CYP2C19基因多態(tài)性與急性冠脈綜合征危險分層的相關(guān)研究[J];中國循證心血管醫(yī)學(xué)雜志;2016年12期

2 楊春光;任淑珍;;冠心病患者中CYP2C19基因多態(tài)性與氯吡格雷抵抗及預(yù)后相關(guān)性研究進展[J];安徽醫(yī)藥;2016年10期

3 劉群;;研究奧美拉唑、雷貝拉唑?qū)ο詽兓颊叩囊炙嵝?yīng)及與CYP2C19基因多態(tài)性的關(guān)系[J];中國實用醫(yī)藥;2016年33期

4 陳建平;林裕龍;;CYP2C19基因多態(tài)性對老年精神科患者血藥濃度的影響[J];中國老年學(xué)雜志;2016年22期

5 馮芹;易興陽;范真;林靜;周強;成文;池麗芬;;細胞色素P450基因變異與氯吡格雷抵抗及血管事件相關(guān)性[J];中華老年心腦血管病雜志;2016年09期

6 翟萬慶;楊麗娟;宋麗艷;周亦;;缺血性卒中氯吡格雷治療后病情進展與CYP2C19基因多態(tài)性的關(guān)系[J];山東醫(yī)藥;2016年33期

7 陳虹;陳慧;;CYP2C19基因型對經(jīng)皮冠狀動脈介入治療后圍術(shù)期心肌梗死的相關(guān)性研究[J];中國循環(huán)雜志;2016年08期

8 張金杰;呂文文;魏傳梅;;伏立康唑臨床應(yīng)用個體差異影響因素的文獻分析[J];中國醫(yī)院藥學(xué)雜志;2016年14期

9 張立國;喻卓;;CYP2C19基因多態(tài)性與云南漢族人群冠心病的相關(guān)性研究[J];中西醫(yī)結(jié)合心腦血管病雜志;2016年14期

10 劉浙波;夏豪;楊洋;李晶;;氯吡格雷藥物代謝相關(guān)基因CYP2C19多態(tài)性對冠心病PCI術(shù)后患者MACE的影響[J];中國心血管病研究;2016年06期

，

本文編號：1586671