Sychev D A, Shprakh V V, Kitaeva E Yu, Mirzaev K B, Mickhalevich I M
Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education 'Russian Medical Academy of Continuous Professional Education', Irkutsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2019;119(3. Vyp. 2):45-52. doi: 10.17116/jnevro201911903245.
To identify clinical and pharmacogenetic predictors of the efficacy of clopidogrel in patients with AI based on CYP2C19 and ABCB1 genotyping. MATERIAL AND METHODS: Clinical and laboratory examinations were performed in 121 patients with AI, and CYP2C19 polymorphisms (CYP2C192 (G681A, rs4244285), CYP2C193 (G363A, rs4986893), CYP2C1917 (C806T, rs12248560), ABCB1 (C3435T, rs1045642), associated with a disturbance of antiplatelet action of clopidogrel. The carriage of polymorphic markers of the studied genes was determined by the method of polymerase chain reaction in real time. RESULTS AND CONCLUSION: In the group with laboratory resistance to clopidogrel, women prevailed (p<0.0001), atherothrombotic subtype was 80% (p=0.0384), the frequency of obesity ischemic stroke was 60% (p<0.0001). Univariate analysis of variance of CYP2C19 polymorphisms CYP2C19 (CYP2C192 (G681A, rs4244285), CYP2C193 (G363A, rs4986893), CYP2C1917 (C806T, rs12248560), ABCB1 (C3435T, rs1045642) in patients with ischemic stroke, demonstrated a significant effect of CYP2C19 genotypes on the indicators of residual reactivity of platelets.
基于CYP2C19和ABCB1基因分型，识别自身免疫性疾病（AI）患者中氯吡格雷疗效的临床和药物遗传学预测因素。材料与方法：对121例AI患者进行了临床和实验室检查，并检测了与氯吡格雷抗血小板作用紊乱相关的CYP2C19基因多态性（CYP2C192（G681A，rs4244285）、CYP2C193（G363A，rs4986893）、CYP2C1917（C806T，rs12248560））以及ABCB1基因（C3435T，rs1045642）。采用实时聚合酶链反应法确定所研究基因多态性标志物的携带情况。结果与结论：在氯吡格雷实验室抵抗组中，女性占优势（p<0.0001），动脉粥样硬化血栓形成亚型占80%（p=0.0384），肥胖缺血性卒中的频率为60%（p<0.0001）。对缺血性卒中患者的CYP2C19基因多态性（CYP2C192（G681A，rs4244285）、CYP2C193（G363A，rs4986893）、CYP2C1917（C806T，rs12248560））以及ABCB1基因（C3435T，rs1045642）进行单因素方差分析，结果显示CYP2C19基因型对血小板残余反应性指标有显著影响。
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