本文選題：外周動脈疾病 + 氯吡格雷�。� 參考：《中國藥房》2017年26期

【摘要】：目的:探討外周動脈疾病(PAD)患者基因多態(tài)性與氯吡格雷抗血小板療效的相關(guān)性。方法:收集近年來國內(nèi)外相關(guān)文獻(xiàn),就PAD患者基因多態(tài)性與氯吡格雷抗血小板療效的相關(guān)性進(jìn)行匯總、分析。結(jié)果與結(jié)論:目前已發(fā)現(xiàn)多種與氯吡格雷抗血小板療效和主要心血管不良事件(MACE)相關(guān)的基因,包括細(xì)胞色素P_(450)(CYP)2C19、腺苷三磷酸結(jié)合盒B亞家族成員1(ABCB1)、對氧磷酶1(PON1)和腺苷二磷酸P2Y12受體(P2Y12)等。其中,CYP2C19~*2、~*3等位基因可能會減弱氯吡格雷的抗血小板作用,兩者的相關(guān)性已被多項研究證實,且結(jié)果具有廣泛的一致性;ABCB1 C3435T、PON1 Q192R位點發(fā)生突變,可能會導(dǎo)致患者對氯吡格雷的反應(yīng)性變低,增加MACE發(fā)生的風(fēng)險,但缺乏大規(guī)模的前瞻性臨床研究,且現(xiàn)有結(jié)果并不一致;尚未發(fā)現(xiàn)PAD患者P2Y12基因多態(tài)性與氯吡格雷療效顯著相關(guān)。
[Abstract]:Objective: To investigate the correlation between gene polymorphism of peripheral arterial disease (PAD) and the effect of clopidogrel on antiplatelet effect. Methods: a collection of relevant literature at home and abroad in recent years was collected, and the correlation between gene polymorphism of PAD patients and clopidogrel antiplatelet effect was collected and analyzed. Conclusion: a variety of clopidogrel and clopidogrel have been found to be anti blood. The genes associated with the plate effect and major cardiovascular adverse events (MACE), including cytochrome P_ (450) (CYP) 2C19, 1 (ABCB1) of the adenosine three phosphate binding cassette B subfamily, PON1 and adenosine two phosphate P2Y12 receptor (P2Y12), which may weaken the antiplatelet effect of clopidogrel, both of which may be reduced. The correlation has been confirmed by a number of studies, and the results have extensive consistency. The mutation of ABCB1 C3435T and PON1 Q192R loci may cause the patients to lower the responsiveness to clopidogrel and increase the risk of MACE, but there is no large prospective clinical study, and the results are not consistent. There has not been much P2Y12 gene in PAD patients. The state of state is significantly related to the efficacy of clopidogrel.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院藥劑科;
【基金】：“重大新藥創(chuàng)制”科技重大專項(No.2012ZX09303016)
【分類號】：R543

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本文編號：2078998