Study on correlation between the gene ploymorphisms of CYP2C19 and the curative effects of clopidogrel in patients with acute cerebral infarction / 临床神经病学杂志

ABSTRACT

Objective To observe the correlation between the gene ploymorphisms of CYP2C19 and the curative effects of clopidogrel in patients with acute cerebral infarction.Methods The gene polymorphisms of CYP2C19 were tested in 171 acute cerebral infarction patients by PCR-restriction fragment length polymorphism method. All participants were treated with clopidogrel for 2 weeks.The platelet aggregation rates before treatment and 1 d, 5 d after treatment were detected.NIHSS and activities of daily living ( ADL) were detected before treatment and 1 week, 2 weeks after treatment.The inhibition rate of platelet aggregation ( IPA) was calculated and analyzed.Results In the 171 patients, homozygous wild CYP2C19 genotype was found in 79 cases (A group), with CYP2C19 *1/*1;heterozygous wild and mutant CYP2C19 genotype was found in 71 cases ( B group ) , including 55 cases with CYP2C19 *1/*2 and 16 cases with CYP2C19 *1/*3; homozygous or heterozygous mutant CYP2C19 genotype was found in 21 cases (C group), including 11 cases with CYP2C19*2/*2, 9 cases with CYP2C19*3/*3 and 1 cases with CYP2C19 *2/*3.The differences of IPA among the 3 groups were statistically significant at 1 d, 5 d after treatment (all P<0.05).Compared with before treatment, the NIHSS scores of the 3 groups at 1 week, 2 weeks after treatment were significantly decreased, and the ADL scores were significantly increased ( all P<0.05 ) . Compared with the A group, the NIHSS scores of B group and C group at 1 week, 2 weeks after treatment were significantly increased, and the ADL scores were significantly decreased (all P<0.05).Multiple Logistic regression analysis showed that smoking (OR=1.584,95%CI1.079-2.136,P=0.004) and CYP2C19 gene polymorphisms (OR=1.837,95%CI1.106 -2.540,P=0.002) were independently correlated with IPA in patients with acute cerebral infarction.Conclusion CYP2C19 gene ploymorphisms have influence on the curative effects of clopidogrel in patients with acute cerebral infarction.