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网络发布日期：2022-08-20
网络发布日期：2022-08-20
中文摘要: 目的 探讨强化氯吡格雷治疗CYP2C19中慢代谢型的急性轻型缺血性卒中(AMIS)患者的疗效与安全性。方法 选取2020年6月至2021年2月徐州市中心医院收治的90例AMIS患者。所有患者于入院当天采用口腔取样，进行床旁即时基因检验，将CYP2C19中慢代谢型的患者随机分为标准组与强化组。采用NIHSS评分和mRS评分评估两组患者抗血小板治疗前后的神经功能缺损程度和预后情况，统计治疗期间不良事件发生率。结果 强化组治疗21 d、90 d NIHSS评分均较标准组下降更显著 （P＜0.05）。治疗90 d，强化组治疗预后良好比例(85.2%,23/27)高于标准组(59.3%,16/27)，差异有统计学意义（χ2=4.523, P=0.033）。两组治疗90 d内卒中复发和出血转化差异无统计学意义（P＞0.05）。结论 强化氯吡格雷治疗能改善CYP2C19中慢代谢型的AMIS患者神经功能缺损程度和90 d预后，不增加出血转化等不良反应事件，但不能降低90 d卒中复发率。
中文关键词: CYP2C19基因多态性 氯吡格雷 强化治疗 轻型卒中 抗血小板
Abstract:Objective To investigate the efficacy and safety of intensive clopidogrel in the treatment of patients with CYP2C19 chronic acute minor ischemic stroke (AMIS). Methods A total of 90 AMIS patients admitted to Xuzhou Central Hospital from June 2020 to February 2021 were selected. On the day of admission, oral sampling was taken for point-of-care (POCT) genetic testing, and patients with CYP2C19 slow-metabolic type were randomly divided into standard group and intensive group. NIHSS score and mRS score were used to evaluate the degree of neurological impairment and prognosis of two groups before and after antiplatelet treatment, and the incidence of adverse events during treatment was counted. Results The NIHSS score of the intensive group decreased more significantly than that of the standard group （P＜0.05）. After 90 days of follow-up, the proportion of good prognosis in the intensive group (85.2%, 23/27) was higher than that in the standard group (59.3%, 16/27), the difference was statistically significant (χ2=4.523,P=0.033). There was no significant difference between the two groups in stroke recurrence and hemorrhage transformation within 90 days of treatment (P>0.05). Conclusion Intensive clopidogrel treatment can improve neurological impairment and prognosis at 90 days of patients with AMIS of CYP2C19 type, without increasing adverse events such as hemorrhage transformation, but without reducing the recurrence rate of 90 days of stroke.
文章编号： 中图分类号：R743.3 文献标志码：A
基金项目:国家自然科学基金(81870943)；江苏省新药研究与临床药学重点实验室开放研究课题（XZSYSKF2020022）
| Author Name | Affiliation |
| MA Dong-jiao*, CHEN Guo-fang, FENG Yao, XIAO Cheng-hua, WANG Yan-qiang | *The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu 221009, China |
引用文本：
马冬娇,陈国芳,冯尧,等.强化氯吡格雷对CYP2C19中慢代谢型轻型卒中患者的疗效与安全性[J].中国临床研究,2022,35(8):1051-1054.
马冬娇,陈国芳,冯尧,等.强化氯吡格雷对CYP2C19中慢代谢型轻型卒中患者的疗效与安全性[J].中国临床研究,2022,35(8):1051-1054.