| 难治性胃食管反流病与CYP2C19基因多态性的相关性研究 |
| 投稿时间：2017-03-06 修订日期：2017-03-07 点此下载全文 |
| 引用本文：肖茹萍,陈阳,卜平.难治性胃食管反流病与CYP2C19基因多态性的相关性研究[J].医学研究杂志,2017,46(11):58-61 |
| DOI：
10.11969/j.issn.1673-548X.2017.11.015 |
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| 基金项目:国家自然科学基金资助项目（81673736）；江苏省普通高校研究生实践创新计划项目（SJLX15-0680） |
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| 中文摘要:目的 对CYP2C19基因多态性于难治性胃食管反流病患者治疗的临床价值进行分析探究。方法 198例难治性胃食管反流病患者行CYP2C19基因多态性检测及分析，根据基因分型分为强代谢组和弱代谢组，每位患者在8周PPI治疗前后均完成RDQ量表及内镜下LA分级（A~D级）。结果 198例患者中强代谢组共160例，平均年龄53.23±14.52岁，弱代谢组共38例，平均年龄52.11±12.13岁，所有患者经奥美拉唑20mg （每日2次）治疗8周后，弱代谢组RDQ平均评分由21.26±9.81下降至16.11±6.24，且内镜下观察食管黏膜损害明显改善，差异有统计学意义（P<0.05），而强代谢组治疗前后RDQ平均评分无明显降低，LA分级差异无统计学意义（P>0.05）。结论 难治性胃食管反流病CYP2C19弱代谢型患者使用质子泵抑制剂可达到更好的疗效，理论上，强代谢型患者加大PPI剂量可获得预期效果，临床医师可依据代谢分型实现个体化用药，合理化用药。 |
| 中文关键词:难治性 胃食管反流病 CYP2C19 基因多态性 |
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| Research on CYP2C19 Genetic Polymorphism with Refractory Gastroesophageal Reflux Disease |
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| Abstract:Objective To analyze and explore the clinical value of CYP2C19 genetic polymorphism in the treatment of refractory gastroesophageal reflux disease.Methods The CYP2C19 genetic polymorphism was detected and analyzed in 198 RGERD patients. According to genotyping, the patients were divided into extensive metabolism and poor metabolism. Each patient was filled in RDQ and LA Classification(from A to D) by endoscopy before and after 8 weeks of PPI treatment.Results There were 160 cases in EM group,mean age 53.23±14.52 years old. There were 38 cases in PM group, mean age 52.11±12.13 years old. And all patients were treated with omeprazole 20 mg (twice daily).The mean score of RDQ in the PM group was significantly decreased after 8 weeks, and the esophageal mucosal lesion was significantly improved by endoscopy(P<0.05), but there was no significant difference in EM group with RDQ and LA (P> 0.05).Conclusion The RGERD patients with poor metabolism group of CYP2C19 using proton pump inhibitors can achieve better efficacy. Theoretically, increasing the PPI dose can achieve the desired effect in the patients of EM group. So the clinician can be based on metabolic typing to achieve individualized medication and rationalization of medication. |
| keywords:Refractory Gastroesophageal reflux disease CYP2C19 Genetic polymorphism |
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