CYP2C19、ApoE基因多态性检测指导用药对急性脑梗死患者疗效及认知功能的影响

Effects of CYP2C19 and ApoE Gene Polymorphism Detection on Guiding Medication on Therapeutic Effect and Cognitive Function in Patients with Acute Cerebral Infarction/HUANG Jianfeng， YI Fei， ZHANG Lujiao， ZHONG Youyou. //Medical Innovation of China， 2025， 22（12）： 077-080

[Abstract]Objective： To observe the efects of cytochrome P450 2C19 （CYP2C19） and apolipoprotein E （ApoE）gene polymorphism detectionon guiding medication ontherapeutic effect and cognitivefunction in patients with acute cerebral infarction （ACI）.Method：A total of 80ACIpatients admitted to Pingxiang People's Hospital from September 2022 to February 2024 were selected and dividedintotwo groups according torandom number table method， with 40 cases in each group.The control group was given routine treatment， and the experimental group was given CYP2C19 and ApoE gene polymorphism detection to guide medication.Blood lipid indexes[low-density lipoprotein cholesterol （LDL-C），high-densitylipoproteincholesterol （HDL-C）and total cholesterol （TC）]，ontreal cognitive assessment （MoCA）， modified Rankin scale （MRS）and national institutes of health stroke scale （NIHSS）scores and efficacy and adverse reactions were compared between the two groups before and after treatment.Result：Thetotalefectiverateofexperimentalgroupwashigherthanthatofcontrolgroup，thedifference was statistically significant （ P <0.05）. After treatment， LDL-C and TC of experimental group were lower than those of control group，andHDL-C was higher than that ofcontrolgroup，thedifferences were statistically significant （ P <0.05）.After treatment，MoCA score of experimental groupwas higher than thatof control group，MRS and NIHSS scores were lower than those of control group， the differences were statistically significant （ P <0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （ P >0.05）. Conclusion： CYP2C19 andApoE gene polymorphismdetection to guide medicationis beneficial tobeter improve thebloodlipidlevels and cognitive function of ACI patients， and improve the clinical efficacy.

[Key words] Acute cerebral infarction Cytochrome P450 2C19 Apolipoprotein E Gene polymorphism Cognitive function

临床对急性脑梗死（ACI）一般通过阿司匹林及氯吡格雷等予以抗栓治疗，其中氯吡格雷不能直接产生抗血小板功效，需要在细胞色素P450家族成员2C19（CYP2C19）基因编码的相应细胞色素P450作用下转化成具有抗血小板活性的物质，从而阻止血小板聚集。（剩余6051字）