氯吡格雷是临床抗血小板治疗的常用药,目前多数观点认为氯吡格雷需经CYP2C19催化生成活性产物,CYP2C19基因多态性与氯吡格雷的代谢水平、血小板反应性以及主要不良心血管事件的发生密切相关;但与之矛盾的是,近几年有观点认为催化氯吡格雷代谢的关键酶并不是CYP2C19而是CYP3A4/5,CYP2C19可能只负责催化少部分的氯吡格雷.现就这两个不同的观点做一综述.“,”Clopidogrel is an universal clinical antiplatelet agent .At present,most viewpoints state that clopidogrel is a CYP 2C19 sub-strate and must be catalyzed by CYP2C19 to produce the active product .CYP2C19 gene polymorphism is closely related with the level of clo-pidogrel active metabolite,platelet reactivity,and major adverse cardiovascular events .On the contrary,clopidogrel is recently considered to be primarily a CYP3A4/5 substrate and that CYP2C19 and CYP2C19 has a minor role in the metabolism of clopidogrel .We will focus on the two conflict views about clopidogrel metablism in this review .