支架内血栓与CYP2C192CYP2C193基因多态性的相关性研究.doc

支架内血栓与CYP2C192CYP2C193基因多态性的相关性研究 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：支架内血栓与CYP2C192CYP2C193基因多态性的相关性研究 1 2 结果 4 3 讨论 5 文2：妊高征与血管紧张素转换酶基因多态性的相关性研究 6 1 资料和方法 7 2 结果 8 3 讨论 8 参考文摘引言： 9 原创性声明（模板） 11 文章致谢（模板） 11 正文 支架内血栓与CYP2C192CYP2C193基因多态性的相关性研究 文1：支架内血栓与CYP2C192CYP2C193基因多态性的相关性研究 [Abstract] Objective To investigate the relatiohip of coronary intervention stent thrombosis with CYP2C19 gene polymorphism. Methods As retrospective single center study， a total of 120 patients with acute coronary syndrome from 2000 to 2015 in Beijing Anzhen Hospital， Capital Medical Univeity were selected. 40 patients had coronary intervention stent thrombosis were taken as the ST group. 80 patients without stent thrombosis after percutaneous coronary intervention were taken as the control group. After the patients received adequate Clopidogrel pretreatment， all of them were accepted detection of gene polymorphism. Results G/G， A/A ， G/A genotype frequencies of CYP2C19*2 were 5 cases （%）， 30 cases （%）， 5 cases （%） in the ST group； which were 37 cases （%）， 42 cases （%）， 1 case （%） in the control group； the mutation rate of A was % vs % （P ）. The level of low deity lipoprotein had significantly statistically difference between the ST group and the control group （P ）. Conclusion Stent thrombosis has correlation with CYP2C19*2 gene mutatio， but the relatiohip of stent thrombosis with CYP2C19*3 gene mutatio is still unclear. Low deity lipoprotein levels can affect stent thrombosis。 [Key words] Stent thrombosis； Clopidogrel resistance； CYP2C19 genetic polymorphism 经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）已经成为目前治疗冠状动脉粥样硬化性心脏病的主要手段。PCI后支架内血栓形成直接影响患者预后，增加死亡率及再住院率，对社会造成巨大的经济负担[1]。冠脉介入术后支架内血栓形成分为急性（1 d～1个月）、晚期（1个月～1年）和极晚期（1年）[2]。影响支架内血栓形成的因素较多，如支架贴壁不良、血液病、药物抵抗等，其中，氯吡格雷抵抗为主要因素[3]，发生率为%～%[4]。氯吡格雷属于噻吩吡啶类药物，是一种前体药物，经过CYP转化成活性代谢产物。细胞色素P450 CYP2C19酶是氯吡格雷转化过程中的关键酶，故CYP2C19基因的多态性与氯吡格雷抵抗密切相关[5-7]。本实验回顾性分析支架内血栓形成与CYP2C19基因多态性的相关性。　1 资料与方法 一般资料 本实验为回顾性单中心研究，入选2000