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目的:探讨PCR熔解曲线法检测CYP2C19基因型及其初步临床应用。方法:选取240例2015年01月-2015年12月来我院心内科住院或门诊的长期服用氯吡格雷治疗的冠心病患者,通过CYP2C19基因检测系统对CYP2C19﹡1、CYP2C19﹡2和CYP2C19﹡3突变位点进行检测,并根据CYP2C19基因型进行药物代谢分组,探讨其临床应用价值。结果:240例患者中,CYP2C19﹡1、CYP2C19﹡2和CYP2C19﹡3等位基因频率,分别为60%,35%和5%,其中弱代谢患者(基因型为CYP2C19﹡2/﹡3)的检出率为4.2%;随机10例样本抽样测序验证符合率为100%。结论:PCR熔解曲线法检测CYP2C19基因具有快速、特异性强、准确率高等特点,适合于临床辅助诊断,是实现临床安全、合理用药的有效手段。
Objective: To investigate the CYP2C19 genotype by PCR melting curve and its preliminary clinical application. Methods: A total of 240 CHD patients treated with long-term clopidogrel inpatient or outpatient department from January 2015 to December 2015 were enrolled in this study. CYP2C19 * 1, CYP2C19 * 2 and CYP2C19 * 3 mutation sites were detected, and according to CYP2C19 genotypes for drug metabolism group, to explore its clinical value. Results: The frequencies of CYP2C19 * 1, CYP2C19 * 2 and CYP2C19 * 3 alleles in 60 patients were 60%, 35% and 5%, respectively. Among them, the patients with mild metabolic syndrome (genotype CYP2C19 * 2 / * 3) The detection rate was 4.2%. The sampling rate of 100 random samples was 100%. Conclusion: PCR melting curve analysis of CYP2C19 gene with fast, specific, high accuracy, suitable for clinical diagnosis, is an effective means to achieve clinical safety and rational use of drugs.