目的：探讨趋化素样因子超家族成员5（CKLF-like MARVEL transmembrane member 5，CMTM5）基因rs723840单核苷酸多态性与阿司匹林治疗下血小板高反应性的相关关系。方法：采用临床单组观察试验研究设计方法，共入选210例北京大学第一医院老年内科住院患者，采用光学比浊法测定0.5 g/L花生四烯酸（arachidonic acid，AA）诱导的血小板聚集率（platelet aggregation ratio，PR），阿司匹林治疗下血小板高反应性（high on aspirin platelet reactivity，HAPR）定义为PR≥3/4 PR界值。将入选患者按照PR分为HAPR组和非血小板高反应性组（No-HAPR）。采用焦磷酸测序法测定CMTM5基因rs723840单核苷酸多态性在HAPR组和No-HAPR组的基因型及等位基因分布频率，采用卡方检验统计分析基因型与等位基因在两组间的差异。结果：CMTM5基因rs723840多态在两组间基因型分布频率皆符合Hardy-Weinberg平衡定律，3种基因型（CC型、CT型和TT型）分布频率在HAPR组和No-HAPR组分别为48.4%、51.6%、0.0%和73.7%、22.9%、0.034%， 3种基因型在两组间分布频率差异存在统计学意义（P=0.004），C、T等位基因分布频率在两组间差异亦有统计学意义（P=0.031，OR=2.002，95% CI：1.056~3.793）。Logistic回归校正了年龄、性别、体重指数、吸烟、高血压、糖尿病及高脂血症等冠心病易患因素后，CMTM5基因rs723840单核苷酸多态性仍与冠心病患者HAPR的发生存在显著相关性。结论：CMTM5基因单核苷酸多态位点rs723840与冠心病患者血小板高反应性发生存在显著相关性。

Objective： To elucidate the correlation between the single nucleotide polymorphism of CKLF-like MARVEL transmembrane member 5 (CMTM5) gene rs723840 and the occurrence of high on aspirin platelet reactivity (HAPR). Methods:The present study is a case-control study. A total of 210 hospitalized patients in Peking University First Hospital were enrolled. Aspirin response was assessed by 0.5 g/L arachidonic acid (AA)-induced platelet aggregation ratio (PR), and ≥3/4 quartile of PR of the population was defined as HAPR. Accordingly all the enrolled 210 coronary artery diseases (CAD) patients were divided into HAPR group and No-HAPR group. The genotypes were determined by polymerase chain reaction (PCR) and sequencing analysis for rs723840 of CMTM5 gene. Results:The genotype frequencies in rs723840 C>T of CMTM5 gene conformed well to the Hardy-Weinberg equilibrium in both HAPR group and No-HAPR group. Between the two groups, the genotypes frequencies in HAPR and No-HAPR groups were 48.4%, 51.6%, 0.0% and 73.7%, 22.9%, 0.034%, respectively (P=0.004). The C, T allele frequencies were significantly different in the two groups (P=0.031,OR=0.501, 95%CI： 0.264-0.947). Conclusion:Our study finds a significant correlation between CMTM5 gene rs723840 polymorphism and high on aspirin platelet reactivity.