ABCB1基因3435C>T单核苷酸多态性与冠状动脉支架内再狭窄

蒋智; 刘微; 贾中申; 梁青龙; 王咏梅; 冯琳; 穆庆海; 刘然; 周松; 李天纵; 李安洁; 韦方

doi:10.13201/j.issn.1001-1439.2019.04.008

ABCB1基因3435C>T单核苷酸多态性与冠状动脉支架内再狭窄

- 1. 贵州省人民医院心内科, 贵州省心血管病研究所(贵阳, 550002);
- 2. 河源市人民医院心内科
基金项目:
国家自然科学基金地区科学基金（No：81460050）；贵州省科技厅贵州省人民医院联合基金课题（黔科合LS字[2016]014）；贵州省“千层次”创新性人才培养（No：GZSYQCC[2015]006）；国家临床重点专科建设项目（国卫办医函[2013]544号）；贵州省科学技术厅临床研究中心项目（黔科合平台人才[（2017）5405]）

详细信息

通讯作者: 韦方,E-mail:w13639087323@qq.com

中图分类号: R541.7

收稿日期: 2018-11-20

ABCB1 3435C>T Single Nucleotide Polymorphism is Related to In-Stent Restenosis in Patients with Coronary Artery Disease

- 1. Department of Cardiology, Guizhou Province People's Hospital, Guiyang, 550002, China;
- 2. Department of Cardiology, Heyuan People's Hospital

More Information

Corresponding author: WEI Fang, E-mail: w13639087323@qq.com

Received Date: 20 November 2018

摘要

摘要: 目的：探讨多药耐药基因（ABCB1）3435C>T单核苷酸多态性与冠状动脉（冠脉）药物涂层支架术后支架内再狭窄（in stent restenosis，ISR）的相关性。方法：纳入2014-01-2017-12冠脉支架术后的患者714例，复查冠脉造影判定ISR，将患者分为ISR组（82例）和non-ISR组（632例），用PCR-RFLP法检测ABCB1 3435C>T基因型，并分析其在ISR和non-ISR组的分布差异，用Logistic回归分析方法分析ISR的独立危险因素。结果：3435C>T的3种基因型和T等位基因分布频率在ISR组和non-ISR组的差异有统计学意义（P<0.01），T等位基因在non-ISR组的分布比例高于ISR组（P<0.01）。Logistic回归分析显示携带T等位基因和服用钙通道阻滞剂（CCB）与ISR风险降低相关（OR=0.52，95%CI：0.297~0.904，P=0.021；OR=0.47，95%CI：0.255~0.863，P=0.015）。在高血压患者亚组分析中，服用CCB的CT/TT型患者ISR发生率显著低于服用CCB的CC基因型患者（4.8%：15.8%，P=0.002）；未服用CCB的两组基因型间ISR发生率差异无统计学意义。结论：CCB与携带ABCB1T等位基因高血压患者的ISR风险相关，机制可能与T等位基因降低P糖蛋白表达水平和CCB抑制P糖蛋白活性有关。
- 冠心病 /
- 支架内再狭窄 /
- 单核苷酸多态性 /
- 人类ATP结合盒 /
- 钙通道阻滞剂
Abstract: Objective: To explore the effect of ABCB1 3435C>T single nucleotide polymorphism (SNP) on in-stent restenosis (ISR) in patients after coronary drug-eluting stent (DES) implantation.Method: We analyzed data from 714 patients who were implanted with DES from January 2013 to December 2017.ISR was detected by coronary angiography (CAG).The 3435C>T genotypes were identified by PCR-RFLP method and their distribution between ISR and non-ISR group was compared by Chi-square test.A logistic regression model was used to analyze the independent risk factors of ISR.Result: The patients were assigned into ISR and non-ISR group by CAG, with 82 and 632 cases respectively.The distribution of the genotypes and T allele frequency showed difference between groups (P<0.01).The T allele frequency was higher in non-ISR group than that in ISR group (P<0.01).The logistic regression model showed decreased ISR risk by carrying T alleles (OR=0.52, P=0.021) and taking CCB (OR=0.47, P=0.015).The analysis of genotypesubgroup revealed lower ISR risk in patients taking CCB with CT/TT genotype (P<0.01) as compared with CC genotype.However, the ISR risk showed no difference in patients without taking CCB between CT/TT and CC genotype.Conclusion: Taking CCBs is correlated with lower ISR risk in hypertension patients with ABCB1 T alleles.The mechanism may associate with inhibition of P-glycoprotein activity by CCB and lower P-glycoprotein expression level in T allele carriers.
- coronary artery disease /
- in-stent restenosis /
- single nucleotide polymorphism /
- ATP-binding cassette /
- calcium channel blocker

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