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Objective: To investigate the CYP2C19 * 2 gene mutations clopidogrel platelet function after Naoxintong intervention against Qi and blood stasis constitution volunteers. Method: 1, 360 25-55 year-old male physical examination volunteer CYP2C19 * 2 gene polymorphism was detected by polymerase chain - restriction fragment length polymorphism (PCR-RFLP) method. 2, selected from 360 male physical examination volunteers 18 QDBS physique volunteers (CYP2C19 * 1/1 wild-type CYP2C19 * 1 / * 2 mutant heterozygous CYP2C19 * 2 / * 2 mutant pure the zygote 6 each), and signed informed consent, taking clopidogrel 7 days (the first day of a loading dose 30Omg, after 75 mg / d) 7 days after the washout period, Naoxintong (0.8g / 3 / day) pretreatment 5 days, and then continue taking Naoxintong plus clopidogrel 7 days (ibid. usage). Medication before baseline clopidogrel after four hours, 24 hours, 3 days, 7 days, ADP-induced platelet aggregation rate (turbidimetry) were measured; simultaneous determination of the baseline state before medication, clopidogrel 7 days 7 days of washout period, taking the first 5 days and 7 days after combined Naoxintong platelet count, the choice of the flow cytometry method for the determination of the rate of ADP-induced platelet aggregation, CD62P, PAC-1 and enzyme linked immunosorbent adsorbent determination Determination of sCD40L changes. Results: CYP2C19 * 2 genotype distribution with Hardy-Weinberg genetic equilibrium (P gt; 0.05) sample group representation. 2 (1) of the CYP2C19 * 1 / * 1 wild-type drug test before the CYP2C19 * 1 / * 2 mutant heterozygous and the CYP2C19 * 2 / * 2 homozygous mutant BMI values, blood biochemistry, platelet count, ADP-induced platelet aggregation rate and CD62P, PAC-1, sCD40L difference was not statistically significant, the determination of the rate of ADP-induced platelet aggregation turbidimetry and flow cytometry method there is a good correlation (r = 0.397, P = 0.004) ; (2) the three genotype clopidogrel after 4 hours, 24 hours, 3 days and 7 days determination of ADP-induced platelet aggregation (turbidimetry) than before taking were significantly decreased (P lt; 0.0l) CYP2C19 * 2 / * 2 homozygous mutant individuals after taking 4 hours, 24 hours, 3 days and 7 days of determination of ADP-induced platelet aggregation rate was significantly higher than that CYP2C19 * 1 / * 1 wild-type individuals (55.0 persons 5.3 %, 52.1 Guests 2.4%, 52.2 ± 5.2%, 52.9 Guests 3.5% VS 22.2 ± 3.8%, 21.2 ± 2.4%, 23.1 ± 4.5%, 21.2 Guests 2.8%, both P lt; 0.01), CYP2C19 * 1 / * 2 the the mutant heterozygous individuals in between, pairwise comparisons differences were statistically significant (P lt; 0.01); (3) three different genotype brain after pretreatment of the heart through the ADP-induced platelet aggregation rate elution period of 7 days (flow cytometry) compared with the same genotype were significantly decreased (P lt; 0.05), but no significant differences between the different genotypes; (4) the two drugs Naoxintong pretreatment For comparison, the CYP2C19 * 2 / * 2 homozygous mutant individuals platelet aggregation rate (flow cytometry, 2.1 ± 0.2% VS 8.8 ± 1.2%, P lt; 0.05), CD62P (22.2 ± 1.1% VS 26.7 ± 1.9% , P = 0.001), PAC-1 expression rate (20.4 ± 1.2% VS 27.3 ± 3.4%, P lt; 0.01) and of sCD40L (1.2 ± 0.3 VS 2.4 ± 0.4, P lt; 0.05) were significantly decreased; (5 ) combination of two drugs with clopidogrel * 1 / * 1, * 1 / * 2 and * 2 / * 2 three groups of genotypes platelet aggregation rate (flow cytometry) have significantly decreased (respectively 3.5 ± 1.7% vs 7.2 ± 1.5, 2.8 ± 0.8% VS 16.1 ± 2%, 2.1 ± 0.2% VS 19.8 ± 1.6%) (P lt; 0.01). Conclusion: the CYP2C19 * 2 gene mutations reduce the efficacy of clopidogrel anti-platelet aggregation, together Naoxintong to improve the CYP2C19 * 2 gene mutation in patients with clopidogrel efficacy.
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