2022 年第 11 期 第 17 卷

基因多态性对阿司匹林血小板抑制率和用药安全性的影响

Effect of gene polymorphisms on platelet inhibition rate and safety of aspirin

作者：肖飞汪亚南李萌倪受东苗仁华

英文作者：Xiao Fei Wang Yanan Li Meng Ni Shoudong Miao Renhua

单位：安徽医科大学附属巢湖医院药剂科，合肥238000

英文单位：Department of Pharmacy Chaohu Hospital of Anhui Medical University Hefei 238000 China

关键词：阿司匹林；基因多态性；血栓弹力图；安全性

英文关键词：Aspirin;Genepolymorphism;Thromboelastography;Safety

• 摘要：

• 目的 探讨基因多态性对阿司匹林血小板抑制率和用药安全性的影响。方法 收集2021年1月至2022年2月在安徽医科大学附属巢湖医院药剂科治疗药物监测室进行阿司匹林药物基因检测的71例住院患者的临床资料行回顾性分析，均为汉族人群。采用荧光原位杂交技术检测前列腺素内过氧化物合酶1（PTGS1，-842A>G,rs10306144)、血小板膜糖蛋白Ⅲa受体（GPⅢa PlA2，rs5918）和血小板内皮聚集受体1（PEAR1，rs1204133)基因多态性；收集患者血栓弹力图参数来评估血小板抑制率，并记录患者使用阿司匹林后出现的不良反应进行统计分析。结果 71例患者基因型检测结果显示，PTGS1和GPⅢa PlA2基因未发生突变，PEAR1基因突变率为60.6%（43/71）。根据PTGS1(-842A>G,rs10306144)，GPⅢa PlA2(rs5918）和PEAR1 (rs1204133)基因检测结果将71例患者分为野生纯合组（28例，39.4%）和突变组（43例，60.6%），血栓弹力图参数显示2组患者的血小板抑制率差异无统计学意义（P>0.05）。突变组3项及以上血栓弹力图参数异常比例和不良反应发生率均高于野生纯合组［46.5%（20/43）比35.7%（10/28）、27.9%（12/43）比17.9%（5/28）］，但差异均无统计学意义（均P>0.05）。结论 PTGS1(-842A>G，rs10306144)，GPⅢa PlA2(rs5918）和PEAR1 (rs1204133)基因多态性对阿司匹林临床效果及用药安全性无明显影响。

• Objective To investigate the effect of gene polymorphisms on platelet inhibition rate and safety of aspirin. Methods Clinical datas of 71 inpatients who underwent aspirin drug gene testing in the Pharmacy Treatment Drug Monitoring Room of Department of Pharmacy, Chaohu Hospital of Anhui Medical University from January 2021 to February 2022 were collected and analyzed retrospectively. All of them were Han people. Fluorescence in situ hybridization was used to detect prostaglandin-endoperoxide synthase 1(PTGS1, -842A>G, rs10306144), platelet membrane glycoprotein Ⅲa receptor(GPⅢa PlA2, rs5918) and platelet endothelial aggregation receptor 1(PEAR1, rs1204133) gene polymorphisms. Patients′ thromboelastogram parameters were collected to evaluate the platelet inhibition rate, and adverse reactions of patients after use of aspirin were recorded and statistically analyzed. Results The genotyping results of 71 patients in this study showed that PTGS1 and GPⅢa PlA2 genes were not mutated, PEAR1 gene mutation rate was 60.6%(43/71). According to detection result of PTGS1(-842A>G, rs10306144), GPⅢa PlA2(rs5918) and PEAR1(rs1204133) genes, 71 patients were divided into wild homozygous group (28 cases, 39.4%) and mutation group (43 cases, 60.6%). Thromboelastography parameters showed that there was no significant difference in platelet inhibition rate between the two groups(P>0.05). The proportions of three or more abnormal thromboelastography parameters and adverse reactions in the mutant group were higher than those in the wild homozygous group［46.5%（20/43） vs 35.7%（10/28）, 27.9%（12/43） vs 17.9%（5/28）］, while the differences were not statistically significant(both P>0.05). Conclusion PTGS1(-842A>G, rs10306144), GPⅢa PlA2(rs5918) and PEAR1(rs1204133) gene polymorphisms have no significant impact on aspirin clinical efficacy and drug safety.