| 王芬,张蓉,姚亚维,闫再宏.CYP2C19基因多态性对质子泵抑制剂治疗NVUGIB疗效的影响.[J].中南医学科学杂志.,2021,(5):595-598. |
| CYP2C19基因多态性对质子泵抑制剂治疗NVUGIB疗效的影响 |
| Effects of CYP2C19 gene polymorphism on the efficacy of proton pump inhibitors in the treatment of NVUGIB |
| 投稿时间：2021-01-25 修订日期：2021-03-02 |
| DOI：10.15972/j.cnki.43-1509/r.2021.05.024 |
| 中文关键词: 质子泵抑制剂 奥美拉唑 雷贝拉唑 非静脉曲张上消化道出血 |
| 英文关键词:proton pump inhibitor omeprazole rabeprazole non-variceal upper gastrointestinal bleeding |
| 基金项目:廊坊市科技支撑计划项目(2020013090) 作者简介:王芬,硕士,主治医师,研究方向为上消化道出血及上消化道早期病变的早诊早治,E-mail为249228379@qq.com。通信作者闫再宏,主任医师,研究方向为上消化道出血及上消化道早期病变的诊治,E-mail为546716908@qq.com。 |
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| 中文摘要: |
| 目的观察细胞色素P450(CYP)2C19基因多态性对质子泵抑制剂治疗非静脉曲张上消化道出血(NVUGIB)疗效的影响。方法选择102例NVUGIB患者,随机分为奥美拉唑组(n＝51)和雷贝拉唑组(n＝51),奥美拉唑组在常规治疗基础上给予奥美拉唑,雷贝拉唑组在常规治疗基础上给予雷贝拉唑,连续用药5天,检测两组患者CYP2C19基因型,分析CYP2C19基因型对治疗总有效率、止血时间、住院时间以及不良反应发生率的影响。结果奥美拉唑组内慢代谢型(PM)治疗总有效率高于快代谢型(EM)(P＜0.05)；雷贝拉唑组EM型治疗总有效率高于奥美拉唑组(P＜0.05)。雷贝拉唑组内不同基因型间止血时间差异无显著性(P＞0.05)。奥美拉唑组EM型止血时间长于中间代谢型(IM)、PM型,且IM型止血时间长于PM型(P＜0.05)。雷贝拉唑组EM型止血时间短于奥美拉唑组,而PM型止血时间长于奥美拉唑组(P＜0.05)。奥美拉唑组PM型住院时间短于EM型、IM型,且PM型住院时间短于IM型(P＜0.05)。雷贝拉唑EM型住院时间短于奥美拉唑组,而PM型住院时间长于奥美拉唑组(P＜0.05)。结论CYP2C19基因多态性会影响质子泵抑制剂治疗NVUGIB患者的治疗总有效率、止血时间和住院时间,临床可针对不同的CYP2C19基因型患者,采取针对性的药物治疗。 |
| 英文摘要: |
| To observe the effect of cytochrome P450 (CYP) 2c19 gene polymorphism on the efficacy of proton pump inhibitors in the treatment of non variceal upper gastrointestinal bleeding (NVUGIB). Methods102 NVUGIB patients in our hospital from July 2018 to July 2020 were enrolled, and divided into two groups by random number table methods, each with 51 cases. Based on routine treatment, omeprazole group was given omeprazole, and rabeprazole group was given rabeprazole. After 5 days of continuous medication, CYP2C19 genotypes of two groups were detected. The effects of CYP2C19 genotype on total effective rate, hemostasis time, length of hospital stay and incidence of adverse reactions were analyzed. ResultsIn omeprazole group, overall efficiency of poor metabolizers (PM) is higher than that of rapid metabolizers (P＜0.05);The total response rate of EM in rabeprazole group was higher than that in omeprazole group (P＜0.05). There was no significant difference in hemostasis time among different genotypes in rabeprazole group (P＞0.05). In omeprazole group,the hemostatic time of EM type is higher than Intermediate metabolizers (IM) and PM type, and hemostatic time of IM type is higher than PM type (P＜0.05). In rabeprazole group,the hemostasis time of EM type was lower than that in omeprazole group, while hemostasis time of the PM type was higher than that in omeprazole group (P＜0.05). In omeprazole group, the hospitalization time of PM type was lower than that of EM type and IM type, and the hospitalization time of PM type was lower than that of IM type (P＜0.05). The length of hospital stay of rabeprazole EM type group was lower than that of omeprazole group, while the length of hospital stay of PM type group was higher than that of omeprazole group (P＜0.05). ConclusionsCYP2C19 gene polymorphism will affect the total effective rate, hemostasis time and hospitalization time of NVUGIB patients treated with proton pump inhibitors. The targeted therapeutic measures can be taken for different CYP2C19 genotypes clinically. |
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