Résumé
Objective:To explore guidance effect of CYP2C19 gene polymorphism on anti-platelet therapy after per-cutaneous coronary intervention (PCI).Methods:A total of 105 patients with coronary heart disease,who received clopidogrel after PCI,were selected.According to results of CYP2C19 gene polymorphism detection,they were di-vided into normal metabolism group (n=51,fast metabolism type)and poor metabolism group (n=54,medium and slow metabolism type).Platelet inhibition rate induced by adenyl diphosphoric acid (ADP)measured by throm-boelastogram (TEG)and clopidogrel resistance (CR)rate were analyzed and compared between two groups.Re-sults:Normal metabolism group and poor metabolism group occupied 48.57% and 51.43% respectively among the 105 patients (medium metabolism type and slow metabolism type occupied 43.81% and 7.62% respectively in poor metabolism group).Compared with normal metabolism group,there was significant reduction in platelet inhibition rate induced by ADP [(78.14 ± 17.86)% vs.(41.67 ± 12.05 )%] and significant rise in incidence rate of CR (11.76% vs.59.26%)in poor metabolism group,P =0.001 all.Conclusion:CYP2C19 gene polymorphism is an important influencing factor for clopidogrel resistance.Therapeutic effect of clopidogrel after PCI in normal metab-olism group is significantly better than that of poor metabolism group,therefore,CYP2C19 gene polymorphism de-tection is help to guide anti-platelet therapy after PCI.
Résumé
Objective To study the diagnostic values of X-ray,CT and MRI for the hip joint lesion of the patient with ankylosing spondylitis (AS).Methods Totally 180 AS patients underwent the examinations of X-ray,CT and MRI from January 2014 to December 2015,and the hip joint lesion,clinical features and the efficacies of the three imaging techniques were observed.Results The rates for positive findings were 69.44％,71.11％ and 72.22％ respectively by X-ray,CT and MRI,and more than 90％ patients had the lesions occurred at the bilateral hip joints simultaneously.Hip joint lesion of AS had the imaging features of bone marrow and joint space changes,which related to the disease progress closely.Early positive signs consisted of medial joint space narrowing by X-ray,rear joint space narrowing by CT as well as bone marrow fat deposition (BMFD) and bone marrow edema (BME) by MRI.Conclusion X ray,CT and MRI all gain their advantages when used to diagnose the hip joint lesion of AS.X-ray behaves well in early diagnosis of medial joint space narrowing,while have disadvantages in displaying soft tissues and minute structures when compared with CT and MRI.CT displays the minute structure of hip joint clearly,and is not so good at soft tissue resolution as MRI.MRI gains the highest resolution for displaying soft tissues in the three techniques,and can show BMFD,BME and etc which can not be revealed by X-ray and CT.
Résumé
Objective:To explore guidance effect of CYP2C19 gene polymorphism on anti-platelet therapy after per-cutaneous coronary intervention (PCI).Methods:A total of 105 patients with coronary heart disease,who received clopidogrel after PCI,were selected.According to results of CYP2C19 gene polymorphism detection,they were di-vided into normal metabolism group (n=51,fast metabolism type)and poor metabolism group (n=54,medium and slow metabolism type).Platelet inhibition rate induced by adenyl diphosphoric acid (ADP)measured by throm-boelastogram (TEG)and clopidogrel resistance (CR)rate were analyzed and compared between two groups.Re-sults:Normal metabolism group and poor metabolism group occupied 48.57% and 51.43% respectively among the 105 patients (medium metabolism type and slow metabolism type occupied 43.81% and 7.62% respectively in poor metabolism group).Compared with normal metabolism group,there was significant reduction in platelet inhibition rate induced by ADP [(78.14 ± 17.86)% vs.(41.67 ± 12.05 )%] and significant rise in incidence rate of CR (11.76% vs.59.26%)in poor metabolism group,P =0.001 all.Conclusion:CYP2C19 gene polymorphism is an important influencing factor for clopidogrel resistance.Therapeutic effect of clopidogrel after PCI in normal metab-olism group is significantly better than that of poor metabolism group,therefore,CYP2C19 gene polymorphism de-tection is help to guide anti-platelet therapy after PCI.
Résumé
Objective To study the diagnostic values of X-ray,CT and MRI for the hip joint lesion of the patient with ankylosing spondylitis (AS).Methods Totally 180 AS patients underwent the examinations of X-ray,CT and MRI from January 2014 to December 2015,and the hip joint lesion,clinical features and the efficacies of the three imaging techniques were observed.Results The rates for positive findings were 69.44％,71.11％ and 72.22％ respectively by X-ray,CT and MRI,and more than 90％ patients had the lesions occurred at the bilateral hip joints simultaneously.Hip joint lesion of AS had the imaging features of bone marrow and joint space changes,which related to the disease progress closely.Early positive signs consisted of medial joint space narrowing by X-ray,rear joint space narrowing by CT as well as bone marrow fat deposition (BMFD) and bone marrow edema (BME) by MRI.Conclusion X ray,CT and MRI all gain their advantages when used to diagnose the hip joint lesion of AS.X-ray behaves well in early diagnosis of medial joint space narrowing,while have disadvantages in displaying soft tissues and minute structures when compared with CT and MRI.CT displays the minute structure of hip joint clearly,and is not so good at soft tissue resolution as MRI.MRI gains the highest resolution for displaying soft tissues in the three techniques,and can show BMFD,BME and etc which can not be revealed by X-ray and CT.