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目的 探讨脑梗死患者中细胞色素P450 3A5(CYP3A5)基因多态性与氯吡格雷抵抗的相关性.方法 将200例脑梗死患者按服药后的血小板聚集率分为氯吡格雷抵抗(CR)组72例和非氯吡格雷抵抗(NCR)组128例.2组患者均予以氯吡格雷75 mg,qd,口服+阿司匹林100 mg,qd,口服.用基因芯片法检测CYP3 A5 6989基因型与等位基因分布,比较2组患者的血小板聚集率和血栓发生率,并对CYP3 A5 6989与氯吡格雷抵抗之间的相关性进行分析.结果 治疗后,CR组和NCR组的血小板聚集率分别为(58.31±14.73)％和(88.45 ±20.45)％,血栓发生率分别为16.67％(12例/72例)和0.78％(1例/128例),CYP3A5 6989中AA型分布频率分别为48.62％和7.03％,CYP3A56989中GG型分布频率分别为19.44％和58.59％,差异均有统计学意义(均P ＜0.05).CR组和NCR组的A等位基因分别为64.58％和24.22％,G等位基因分别为35.42％和75.78％,差异均有统计学意义(均P＜0.05).结论 在脑梗死患者中,CYP3A5基因多态性与氯吡格雷抵抗间存在着显著的相关性.“,”Objective To investigate the association between P450 3A5 (CYP3A5) gene polymorphism and clopidogrel resistance in patients with cerebral infarction.Methods According to platelet aggregation rate after taking the drug,200 patients with cerebral infarction were divided into clopidogrel resistance (CR) group (n =72 cases) and non clopidogrel resistance (NCR) group (n =128 cases).Two groups were given clopidogrel 75 mg,qd,orally + aspirin 100 mg,qd,orally.The genotype and allele distribution of CYP3A5 6989 were measured by gene chip method.The rates of platelet aggregation and thrombosis were compared between two groups.The relationship between CYP3A5 6989 and clopidogrel resistance was analyzed.Results After treatment,the main indexes in CR and NCR groups were compared:platelet aggregation rates were (58.31 ± 14.73)％ and (88.45 ± 20.45)％,thrombosis rates were 16.67％ (12 cases / 72 cases) and 0.78％ (1 case / 128 cases),type AA in CYP3A5 6989 were 48.62％ and 7.03％,type GG in CYP3A5 6989 were 19.44％ and 58.59％,the differences were statistically significant (all P ＜ 0.05).A alleles in the CR group and NCR group were 64.58％ and 24.22％,G alleles were 35.42％ and 75.78％ with significant differences (all P ＜ 0.05).Conclusion There was a significant correlation between CYP3A5 gene polymorphism and clopidogrel resistance in patients with cerebral infarction.