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。
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 VKORCl-1639AG genotype were 79.6% longer than those with VKORCl-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 VKORCl-1639AA genotype or CYP2C9 * 1/* 1 genotype could reach the target INR val-ue on the seventh day postoperatively. Conclusion: It took longer time for the patients with VKORCl-1639AG genotype to obtain the target INR value and shorter time for patients with CYP2C9 * 1/* 3 genotype to obtain the target INR value. Pa-tients should have their genotype detection before taking the medicine to predict the dose of warfarin.
出处
《药物流行病学杂志》
CAS
2014年第2期98-101,共4页
Chinese Journal of Pharmacoepidemiology
关键词
华法林
基因多态性
起始抗凝
Warfarin
Gene polymorphisms
Initial anticoagulation