张云飞;徐炳欣;赵艳;贺秀华;翟华季;

• 1:许昌市中心医院心内科
• 2:许昌市中心医院药学部

摘要(Abstract)：

目的探讨CYP2C19基因多态性对西酞普兰治疗急性心肌梗死(AMI)后抑郁的影响。方法连续招募137例AMI后抑郁症患者,采用DNA微阵列芯片法检测CYP2C19基因型。依据CYP2C19基因检测结果,将患者分为快代谢组、中等代谢组和慢代谢组,3组患者均在冠心病二级预防的基础之上单用西酞普兰抗抑郁治疗,连续用药6周。记录3组治疗前及治疗后2、4、6周后汉密尔顿抑郁量表17项(HAMD-17)、汉密尔顿焦虑量表14项(HAMA-14)评分及治疗过程中副反应量表(TESS)评分情况,记录3组治疗6周后总有效率,二元Logistic回归分析治疗效果的影响因素。结果快代谢组、中等代谢组和慢代谢组分别有46例(33.6%)、66例(48.2%)和25例(18.2%)患者。治疗前,3组HAMD-17及HAMA-14评分差异无统计学意义(P>0.05);治疗4、6周后3组HAMD-17评分及慢代谢组HAMA-14评分显著低于治疗前,随治疗时间延长逐渐降低,且慢代谢组显著低于快代谢组和中等代谢组(P<0.05);快代谢组和中等代谢组治疗6周后HAMA-14评分显著低于治疗前(P<0.05);治疗过程中,3组TESS评分差异无统计学意义(P>0.05);3组治疗总有效率有显著性差异,且慢代谢组治疗总有效率显著高于快代谢组(P<0.05);二元Logistic回归分析显示,快代谢组患者应用西酞普兰抗抑郁治疗有效可能性为慢代谢组患者的24.3%(OR=0.243,95%CI 0.082～0.721,P=0.011)。结论 CYP2C19基因多态性对AMI患者应用西酞普兰抗抑郁治疗有影响,且慢代谢型患者治疗效果优于快代谢型。

关键词(KeyWords)： 细胞色素P450C19;基因多态性;西酞普兰;急性心肌梗死;抑郁

Abstract:

Keywords:

基金项目(Foundation): 河南省科技发展计划项目(编号:182102310214);; 许昌市重大科技专项(编号:20180113031)

作者(Authors): 张云飞;徐炳欣;赵艳;贺秀华;翟华季;

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