临床药师参与心脏瓣膜置换术后华法林药物基因导向个体化抗凝治疗

Participation of clinical pharmacists in individualized warfarin anticoagulant therapy based on pharmacogenomics in patients after cardiac valve replacement

目的:尝试和建立以基因为导向的华法林个体化抗凝治疗模式,以期提高抗凝疗效,降低患者抗凝治疗风险。方法:临床药师参与心脏瓣膜置换术后患者的抗凝管理,积极探讨患者基因差异对华法林抗凝疗效的影响。结果:心脏瓣膜置换术后患者需接受华法林抗凝治疗,华法林疗效存在明显个体差异,而基因多态性是导致华法林剂量差异的主要原因。结论:传统经验抗凝治疗模式存在一定的盲目性和潜在的危险性。

OBJECTIVE To establish an individualized anticoagulant therapy mode based on pharmacogenomics in order to improve curative efficacy and reduce risks for patients.METHODS Clinical pharmacists participated in the anticoagulant management for patients after cardiac valve replacement to actively explore the influences of genotypes on anticoagulation response of warfarin.RESULTS The patients after cardiac valve replacement received warfarin anticoagulant therapy.There were evidently individualized differences in curative efficacy of warfarin,and gene polymorphism was the major cause.CONCLUSIONTraditional empirical anticoagulant therapy has certain blindness and potential danger.