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目的分析中国健康人群和氯吡格雷个体化治疗会诊患者的细胞色素P450 2C19(CYP2C19)基因分布特点以及医师申请该会诊的选择偏好。方法对231名健康受试者及93名申请会诊的住院患者进行CYP2C19*2和*3等位基因检测,比较2组人群CYP2C19*2、*3的分布频率的差异,向医师发放问卷,调查医师申请氯吡格雷个体化治疗会诊的偏好。结果 231名健康受试者中CYP2C19*2位点的*1/*1、*1/*2、*2/*2型的分布频率分别为48.92%,40.26%,10.82%;CYP2C19*3位点的*1/*1、*1/*3、*3/*3型的分布频率分别为87.88%,11.69%,0.43%。93名申请会诊的住院患者中CYP2C19*2位点的*1/*1、*1/*2、*2/*2型的分布频率分别为33.33%,55.91%,10.75%,CYP2C19*3位点的*1/*1、*1/*3、*3/*3型的分布频率分别为95.70%,4.30%,0。2组人群的CYP2C19*1/*2的分布频率比较差异有统计学意义(P<0.05),CYP2C19*3的分布频率比较差异无统计学意义(P>0.05)。医师倾向于为腺苷二磷酸聚集率不理想和再次血栓的患者申请会诊。结论医师申请会诊的选择偏好可以部分解释患者与健康人基因分布差异的原因。
Objective To analyze the distribution of cytochrome P450 2C19 (CYP2C19) gene in Chinese healthy population and clopidogrel individualized consultation clinicians and the preferences of physicians to apply for the consultation. Methods Two hundred and seventy healthy subjects and 93 inpatients admitted for consultation were tested for CYP2C19 * 2 and * 3 alleles. The differences in the distribution frequency of CYP2C19 * 2 and * 3 between the two groups were compared and questionnaires were sent to the physicians Physician Request Clinic Preferences for Clopidogrel Individualized Treatment. Results The distribution frequency of CYP2C19 * 2 locus was 48.92%, 40.26% and 10.82% respectively in CYP2C19 * 2 locus in 231 healthy subjects. CYP2C19 * 3 locus The distribution frequency of points * 1 / * 1, * 1 / * 3, * 3 / * 3 was 87.88%, 11.69% and 0.43% respectively. The distribution frequencies of CYP2C19 * 2 loci were 93.33%, 55.91% and 10.75% in CYP2C19 * 2 loci and 93% of CYP2C19 * 3 loci The distribution frequency of point * 1 / * 1, * 1 / * 3, * 3 / * 3 type was 95.70% and 4.30% respectively. There was statistical difference in the distribution frequency of CYP2C19 * 1 / * 2 among 0.2 groups (P <0.05). There was no significant difference in the distribution frequency of CYP2C19 * 3 (P> 0.05). Physicians tend to apply for consultation for patients with unsatisfied adenosine diphosphate build-up and thrombosis again. Conclusion The selection preferences of physicians for consultation may partially explain the reasons for the difference in gene distribution between patients and healthy individuals.