基因多态性与华法林的起始给药剂量的相关性研究

Study on the Correlation between Gene Polymorphism and Warfarin Initial Dose

目的:探讨CYP2C9与VKORC1基因多态性对于个体华法林的起始给药剂量的影响,为临床个体化使用华法林提供实验依据。方法:选取某院2014年1月~2016年1月收治的232例心血管疾病患者,平均分为对照组和观察组。对照组采取常规华法林治疗模式,观察组通过基因测序法检测116例患者CYP2C9、VKORC1基因多态性后,分基因型个性化用药,检测不同给药剂量的INR值,统计并分析两组之间的华法林起始给药剂量、治疗效果及不良事件的发生率。结果:相比于对照组,观察组的华法林起始剂量降低,具有统计学差异(P<0.05);不良反应发生率明显减少。结论:在个体化使用华法林的临床疗效中,CYP2C9和VKORC1基因与相应华法林的起始给药剂量及最终治疗疗效存在着密不可分的联系,对心血管疾病给药剂量具有重要性。

Objective：To investigate the effect of polymorphism of CYP2 C9 and VKORC1 gene on the initial dose of warfarin in individuals,and to provide experimental basis for clinical individualized use of warfarin.Methods：A total of 232 cardiovascular patients treated in a hospital from January 2014 to January 2016 were selected and divided into control group and observation group.The control group was treated with routine warfarin.In the observation group,the CYP2 C9 VKORC1 gene polymorphism was detected by gene sequencing method,and the 116 patients were given genotypic individualized drug.The INR values of different doses of warfarin were measured,and the initial dose of warfarin,the therapeutic effect and the incidence of adverse events between the two groups were analyzed.Results：Compared with the control group,the initial dose of warfarin in the observation group was significantly lower than that in the control group,with statistical difference（P〈0.05）,and the incidence of adverse reactions was significantly decreased.Conclusion：In the clinical efficacy of individualized warfarin,CYP2 C9 and VKORC1 genes are closely related to the initial dose of the corresponding warfarin and the final therapeutic effect,which is important for cardiovascular disease dosages.