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目的 探讨威海地区冠心病与脑血管病患者 CYP2C19 基因多态性分布特点,阐述药物基因检测指导临床氯吡格雷个体化用药的重要性.方法 选取 2016-2018 年于威海市中心医院行 CYP2C19 基因多态性检测冠心病与脑血管病患者共964 例.采用等位基因特异 PCR 荧光探针法检测 CYP2C19?2、?3 及?17 等位基因,根据基因型判断代谢表型,并分析性别及疾病临床分型与 CYP2C19 基因多态性的相关性.结果 本研究共检测到 8 种基因型:CYP2C19?1?17、?1?1、?1?2、?1?3、?2?17、?2?2、?2?3、?3?3,其中?1/?1发生率最高,频率为39. 2% ;代谢表型分类:超快代谢型、快代谢型、中间代谢型、慢代谢型的频率分别为1. 5% 、39. 2% 、46. 3% 、13% ,以中间代谢型为主.不同性别、疾病临床分型患者 CYP2C19 基因型、代谢表型比较,差异无统计学意义(P >0. 05) .结论 威海地区冠心病与脑血管病患者 CYP2C19 基因具有多态性,CYP2C19 基因型主要以 CYP2C19?1/?1为主,代谢表型以中间代谢型为主,其等位基因频率和代谢表型分布情况与亚洲人群接近.依据基因型指导氯吡格雷抗血小板治疗对临床个体化用药具有重要意义.“,”Objective To investigate the distribution characteristics of CYP2 C1 9 gene polymor-phism in patients with cardiovascular and cerebrovascular diseases in this area , and to explain the impor-tance of drug gene detection to guide the clinical use of clopidogrel . Methods A total of 9 6 4 patients with cardiovascular and cerebrovascular diseases were selected from the CYP2 C1 9 gene polymorphism in our hospital from 2 0 1 6 to 2 0 1 8 . The CYP2 C1 9?2 , ?3 and ?1 7 alleles were detected by real-time fluorescence quantitative PCR . The metabolic phenotype was judged according to the genotype , and the correlation between gender and clinical classification of diseases and CYP2 C1 9 gene polymorphism was an-alyzed . Results A total of 8 genotypes were detected in this study : CYP2 C1 9?1?1 7 , ?1?1 , ?1?2 , ?1?3 , ?2?1 7 , ?2?2 , ?2?3 , ?3 ?3 , of which ?1/?1 has the highest incidence rate , the frequency is 3 9 . 2 % ; and the metabolic phenotypes : UM ( 1 . 5 % ) , EM ( 3 9 . 2 % ) , IM ( 4 6 . 3 % ) and PM ( 1 3 % ) , the proportion of IM was the most abundant . There was no significant difference in CYP2 C1 9 genotype and metabolic phenotype between clinical isolates of different genders and diseases ( P >0 . 0 5 ) . Conclusion The CYP2 C1 9 gene is polymorphic in patients with cardiovascular and cerebrovascular diseases in this region . The CYP2 C1 9 genotype is mainly CYP2 C1 9?1/?1 , and the metabolic phenotype is mainly intermediate metabolites . The distribution of allele frequency and meta-bolic phenotype of the CYP2 C1 9 gene is similar to that in Asians . According to the genotype , clopidogrel antiplatelet therapy is of great significance for clinical individualized medication .