老年患者VKORC1和CYP2C9基因多态性对华法林应用的影响及分析

Effect of Polymorphism in VKORC1 and CYP2C9 on Warfarin Dosage in Elderly Patients

目的探求遗传因素和非遗传因素对≥60岁老年人华法林应用的影响。方法纳入≥60岁使用华法林的老年患者,收集患者血液样本并检测患者VKORCl和CYP2C9基因型,收集患者临床资料,统计分析遗传因素和非遗传因素对华法林稳定剂量的作用与影响。结果 VKORCl和CYP2C9基因型对华法林剂量有显著影响,VKORC1:1173C>T,体重、AST(谷草转氨酶)、CYP2C9*3 4个变量可以解释23.2%的华法林稳定期用量的变异。结论遗传因素在老年患者华法林作用影响巨大,VKORCl和CYP2C9基因多态性检测同样适用于老年患者的华法林个体化用药。

OBJECTIVE To explore the effect of genetic factors and non-genetic factors on warfarin dosage in patients older than 60 years. METHODS Patients older than 60 years were included. Blood samples were collected and tested for VKORC1 and CYP2C9 genotypes. And the clinical data were collected. The effects of genetic factors and non-genetic factors on stable dosage of warfarin were statistically analyzed. RESULTS VKORC1 and CYP2C9 genotypes had a significant effect on warfarin dosage. The four variables, ie, VKORC1 ： 1173C 〉 T, body weight, aspartate aminotransferase （AST）, and CYP2C9 ＊ 3 could explain 23.2% of the stable warfarin dosage variation. CONCLUSION Genetic factors have significant effect on warfarin dosage in elderly patients, so genetyp- ing on VKORC1 and CYP2C9 can be applied to individualize warfarin dosage in elderly patients.