应用基因多态性探讨吉林地区人群华法林稳定剂量

Application of Genetic Polymorphism to Investigate the Stable Dose of Warfarin in Jilin Population

目的通过对吉林省某三甲医院长期服用华法林患者的相关资料及检测结果进行分析,建立华法林药物基因组学剂量预测模型,评价模型的准确性,期望为患者个体化用药提供合理化建议。方法选择2016年6月—2018年7月住院并长期服用华法林抗凝吉林地区汉族患者190例作为研究对象。收集患者的一般信息、生活习惯、临床资料、CYP2C9和VKORC1基因检测结果。数据分析采用SPSS 22.0统计软件。结果吉林地区华法林日稳定剂量模型:D(mg/day)=[1.369-0.003×(Age,in year)+0.241(BSA,m^2)-0.254×CYP2C9~*3(~*1~*1=0,~*1/~*3=1)+0.066~*VKORC1-1639A> G(AA=0,AG=1)]~2。该模型可以解释69.5%吉林省汉族患者华法林剂量个体差异(P <0.001)。结论本研究得出的模型能够解释69.5%的华法林剂量个体差异,CYP2C9和VKORC1是影响华法林日稳定剂量的原因之一。

Objective Through the long-term use of warfarin in patients with relevant information and analyze the test results,the establishment of warfarin pharmacogenomics dose prediction model and the prediction model hoping to provide reasonable individualized medication patients suggestions.Methods 190 patients of Han nationality in Jilin area who were hospitalized from June 2016 to July 2018 and took warfarin for a long time were selected as subjects.The general information,lifestyle,clinical data,CYP2C9 and VKORC1 gene test results were collected.The data were analyzed by SPSS 22.0 statistical software.Results The stable dose model of the warfarin day in Jilin area:D(mg/day)=[1.369-0.003×(Age,in year)+0.241(BSA,m^2)-0.254×CYP2C9*3(*1*1=0,*1/*3=1)+0.066*VKORC1-1639A>G(AA=0,AG=1)]2.The model can explain the individual difference of warfarin dosage in 69.5%of Han patients in Jilin province(P<0.001).Conclusion The model can explain 69.6%of the individual differences in warfarin doses,CYP2C9 and VKORC1 are one of the reasons for the stable dose of warfarin.