周沛,聂小燕,孙宇彤,孙浩宁,史轶群,特日格乐,聂文畅,郭萌,刘健,崔鸣

• 1:北京大学人民医院心血管内科
• 2:北京大学医学部药学院药事管理与临床药学系
• 3:北京大学第三医院心血管内科

摘要(Abstract)：

目的 分析血小板内皮聚集受体-1(PEAR1)基因多态性对冠心病患者临床预后的影响。方法 连续纳入2016年12月至2018年12月于北京大学人民医院心血管内科行冠状动脉介入诊疗并接受阿司匹林和氯吡格雷双联抗血小板治疗的冠心病患者。检测患者PEAR1基因（rs822441、rs12041331）以及CYP2C19基因（rs4986893、rs4244285）单核苷酸多态性（SNP）。临床随访2年，主要终点是全因死亡、非致死性心肌梗死、缺血性卒中和不稳定型心绞痛（UA）导致再次住院的复合事件。在校正CYP2C19功能缺失型（LOF）等位基因及其他混杂因素后，利用Cox回归分析研究PEAR1基因多态性对冠心病患者临床预后的影响。结果 共纳入411例冠心病患者，平均随访时间（737.7±0.7）d，共有22例发生主要终点事件。将年龄、总胆固醇、肌酐、左主干病变、CYP2C19LOF等位基因携带状态作为协变量纳入多因素Cox回归分析中，结果显示PEAR1基因SNPrs822441、rs12041331与主要终点事件风险无相关性，但rs822441突变型等位基因携带者发生UA导致再次住院事件风险升高（校正HR 5.084,95%CI 1.071～24.131,P=0.041）。结论 PEAR1基因SNP rs822441与冠心病患者临床预后具有相关性。

关键词(KeyWords)： 冠心病;血小板受体;基因多态性;抗血小板治疗;PEAR1基因

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（81970294）;; 北京市自然科学基金项目（7212119）

作者(Author): 周沛,聂小燕,孙宇彤,孙浩宁,史轶群,特日格乐,聂文畅,郭萌,刘健,崔鸣

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