Abstract：Objective: To observe the association of serum neuron-specific enolase (NSE), tumor necrosis factor-α (TNF-α) and CYP2C19 gene polymorphism with clopidogrel treatment outcome in patients with cerebral infarction. Methods: A total of 104 patients with cerebral infarction in the hospital were enrolled from November 2021 to November 2023, and were treated with clopidogrel. CYP2C19 gene polymorphism and levels of NSE and TNF-α were detected, and the relationship with clopidogrel treatment outcome was analyzed. Results: There was a statistical difference in the distribution of CYP2C19 gene metabolic type between good prognosis group and poor prognosis group (P<0.05). The platelet aggregation rate and serum NSE and TNF-α levels in poor prognosis group were higher than those in good prognosis group, with statistical differences (P<0.05). The platelet aggregation rate, NSE and TNF-α levels revealed statistical differences among different metabolic types of CYP2C19 gene (P<0.05). The platelet aggregation rate, NSE and TNF-α of slow metabolic type and intermediate metabolic type were higher than those of fast metabolic type, with statistical differences (P<0.05). The proportion of patients with diabetes mellitus and age were higher or older in poor prognosis group than those in good prognosis group, with statistical differences (P<0.05). Multivariate Logistic regression analysis suggested that diabetes mellitus, CYP2C19 gene slow metabolic type, age, NSE and TNF-α were risk factors affecting the clopidogrel treatment outcome (P<0.05). ROC curve analysis revealed that the AUC, sensitivity and specificity of the combined evaluation of the five indicators were 0.843, 0.953 and 0.574 respectively. Conclusion: The poor prognosis of patients with cerebral infarction after clopidogrel treatment is related to the slow metabolic type of CYP2C19 gene and the levels of serum NSE and TNF-α, and has certain evaluated value on evaluating the treatment outcome.
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2025, Vol. 31 
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