目的 在急性冠脈綜合征（ACS）患者中開展替格瑞洛的藥物基因組學研究，以期發(fā)現(xiàn)能預(yù)測替格瑞洛出血不良反應(yīng)個體差異的遺傳學因素。方法 對中國人民解放軍聯(lián)勤保障部隊第九〇〇醫(yī)院2018年收治的75例本地區(qū)漢族符合入排標準的 ACS患者，進行 SLCO1B1、UGT2B7、P2Y12、PEAR1、ITGA2B、ITGB3的單核苷酸多態(tài)性檢測，同時收集并記錄患者的性別、年齡、體質(zhì)量指數(shù)（BMI）、合并癥、患病類型、吸煙狀況、飲酒狀況、生化指標以及最大血小板聚集率及出血事件。通過二元 Logistic回歸分析法分析替格瑞洛出血不良反應(yīng)與基因多態(tài)性的相關(guān)性。結(jié)果 二元 Logistic回歸分析結(jié)果表明，SLCO1B1 rs4149056、PEAR1 rs12407843、PEAR1 rs77235035與替格瑞洛出血風險顯著相關(guān)，而調(diào)整混雜因素后的分析結(jié)果顯示上述基因型與替格瑞洛出血不良反應(yīng)沒有顯著相關(guān)性，均不能作為預(yù)測替格瑞洛出血不良反應(yīng)的獨立遺傳因素（P＞0.05）。結(jié)論 未發(fā)現(xiàn)替格瑞洛轉(zhuǎn)運受體、作用靶點以及血小板膜受體相關(guān)的基因單核苷酸多態(tài)性與替格瑞洛導致的出血不良反應(yīng)有顯著相關(guān)性。

Objective To develop a pharmacogenomics study of ticagrelor in patients with acute coronary syndrome (ACS) to identify the genetic factors that can predict individual differences in adverse reactions of ticagrelor hemorrhage. Methods 75 ACS patients of Chinese Han in The 900th Hospital of Joint Logistics Support Force of Chinese PLA in 2018 who met the entry criteria were recruited. The patient was tested for the single nucleotide polymorphisms of SLCO1B1、 UGT2B7、 P2Y12、 PEAR1、 ITGA2B、ITGB3. Gender, age, BMI, complication, disease type, smoking status, drinking status, biochemical index and adverse reactions of hemorrhage of patient were collected and recorded. The correlation between adverse reactions of ticagrelor hemorrhage and gene polymorphism was analyzed by Binary Logistic Regression. Results The results of Binary Logistic Regression analysis showed that SLCO1B1 rs4149056、 PEAR1 rs12407843 and PEAR1 rs77235035 were significantly correlated with the risk of ticagrelor hemorrhage, while the results of adjusted confounding factors showed that the above genotypes were not significantly correlated with the adverse reactions of ticagrelor hemorrhage, and could not be used as independent genetic factors to predict the adverse reactions of ticagrelor hemorrhage (P＞0.05). Conclusion There was no significant correlation between single nucleotide polymorphisms of genes associated with ticagrelor transporters, targets, and platelet membrane receptors and adverse reactions of hemorrhage caused by ticagrelor.

R971

中國人民解放軍聯(lián)勤保障部隊第九〇〇醫(yī)院課題-軍民融合臨床研究專項（2018J03）