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| 基因多态性对HVR患者华法林起始抗凝效果的影响 |
| Research on the Influence of VKORC1 and CYP2C9 Polymorphisms with Warfarin Initial Anticoagulant Effect |
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| DOI： |
| 中文关键词: 华法林 基因多态性 起始抗凝 |
| 英文关键词:Warfarin Gene polymorphisms Initial anticoagulation |
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| 中文摘要: |
| 摘 要 目的:观察心脏瓣膜置换术后患者基线信息和CYP2C9*3、VKORC1-1639A/G基因多态性与术后华法林初始抗凝效果的关系。方法： 收集患者的遗传信息和人口统计学信息，同时记录测得的INR值、华法林剂量、达标天数等。结果：纳入的172例患者中，VKORC1-1639AG型患者达到目标INR的时间与AA型相比约延长79.6%；CYP2C9*1/*3型患者达到目标INR的时间与*1/*1型相比约缩短50.9%；大部分VKORC1-1639AA（77.6%）和 CYP2C9*1/*1（68.2%）基因型患者能够在术后第7日达到目标INR值；VKORC1 1639AG突变杂合子患者只有23%术后第7日达到目标INR值，且无抗凝过度现象；CYP2C9*1/*3突变杂合子患者全部达到目标INR值，且较易引起抗凝过度。结论：华法林起始抗凝阶段，VKORC1 1639AG突变型患者更难达到目标INR值，CYP2C9*1/*3突变型患者更易达到目标INR值。患者用药前可进行基因型检测，预测华法林用药剂量。 |
| 英文摘要: |
| ABSTRACT Objective::To explore the relationship between the baseline information and the reponse of VKORC1 and CYP2C9 polymorphisms of patients after heart valve replacement(HVR) to warfarin during initial anticoagulation. Methods:The patients’ genetic and demographic information was collected and their INR value, dosage of warfarin and days of obtaining target INR value were recorded. Results: Of 172 consecutive patients, the mean time to target INR value for the patients with VKORC1-1639AG genotype were 79.6% longer than those with VKORC1-1639AA genotype; the mean time to target INR value for the patients with CYP2C9*1/*3 genotype was 50.9% shorter than those with CYP2C9*1/*1 genotype; most patients with VKORC1-1639AA genotype or CYP2C9*1/*1 genotype could reach the target INR value on the seventh day postoperatively. Conclusion:It took longer time for the patients with VKORC1-1639AG genotype to obtain the target INR value and shorter time for patients with CYP2C9*1/*3 genotype to obtain the target INR value. Patients should have their genotype detection before taking the medicine to predict the dose of warfarin. |
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