Clinical Significance Of CYP2C19 Gene Polymorphism Etection In Patients With Acute Mild Ischemic Stroke

Objective: In this study,CYP2C19 genotype was detected in patients with acute mild ischemic stroke,and the frequency and genotype distribution of CYP2C19 allele mutation were preliminarily understood.The relationship between CYP2C19 genotype and early neurological deterioration and recurrence of stroke was explored,which could provide reference for clopidogrel antiplatelet therapy and prevention in patients with mild ischemic stroke.Methods: After admission,the patients with acute cerebral infarction were examined by CT,head MRI+DWI,blood routine,biochemical routine,electrocardiogram,carotid artery color Doppler ultrasonography and cardiac color Doppler ultrasonography.The NISS scores of 166 patients who met the criteria were assessed as END,42 patients in END group(group A)and 42 patients in non-END group.124 patients in group B were followed up after 3 months.155 patients who met the criteria were divided into 54 patients in group C and 98 patients in group D.The collected data were processed and analyzed.Results:1.In this study,166 patients with cerebral apoplexy met the inclusion criteria,including42 patients in the END group(group A)and 124 patients in the non-end group(group B).The basic conditions of the two groups were compared,and the differences in gender,age,hypertension,diabetes and carotid atherosclerosis were not statistically significant(P > 0.05).1.The wild-type CYP2C19*1(68.07%)is the dominant allele of CYP2C19*2 and CYP2C19*3 in mild ischemic stroke patients,and the mutant alleles CYP2C19*2 and CYP2C19*3 account for 21.08% and 10.85%,respectively.There were 86 patients(51.81%)with fast metabolism of CYP2C19 genotype,54 patients(32.53%)with moderate metabolism,and 26 patients(15.66%)with slow metabolism(CYP2C19*2/*2,CYP2C19*2/*3).2.The proportion of slow metabolism type(35.71%)and CYP2C19*2 allele(38.10%)in the END group was significantly higher than that in the non-end group(p < 0.01).The proportion of fast metabolism type(53.23%)and CYP2C19*1 allele(70.96%)in the non-end group was significantly higher than that in the END group(p < 0.01).There was no statistically significant difference between the END group and the non-end group in the distribution of midmetabolism and CYP2C19*3 alleles(P> 0.05).4.In patients with acute light stroke,stroke type slow metabolism ratio did not relapse group group(57.1%)was obviously higher than stroke recurrence rate(20.4%)(p <0.01),the light did not relapse group of CYP2C19 * 2 allele ratio of stroke group(38.9%)were significantly higher than those of light stroke recurrence rate(15.8%)(p <0.01),recurrent stroke and stroke recurrence group of metabolic type,there was no statistically significant difference between CYP2C19 * 2(p > 0.05).Conclusion:1.The wild-type CYP2C19*1 is the dominant allele of CYP2C19*1 in patients with acute light stroke in Bengbu,and the mutant alleles include CYP2C19*2 and CYP2C19*3.No CYP2C19*17 allele has been found.The most common CYP2C19 genotype is the fast metabolism genotype(CYP2C19*1/*1),and no CYP2C19*3/*3genotype has been found yet.2.CYP2C19 gene polymorphism is correlated with light stroke END and recurrence.Light stroke patients with slow metabolism are more prone to END and recurrence than patients with fast metabolism and moderate metabolism.3.There was no significant correlation between CYP2C19*3 allele mutation and light stroke END and recurrence.