基于CYP2C9和VKORC1基因型检测的华法林个体化用药分析

Analysis of individualized use of warfarin based on CYP2C9 and VKORC1 genotypes

目的通过分析CYP2C9和VKORC1基因型检测的患者临床资料,为指导华法林个体化用药提供参考。方法选择2016年1月至2018年8月进行CYP2C9和VKORC1基因型检测的患者48例,分析患者病例资料、基因型、华法林使用剂量和国际标准化比值(INR)。结果 48例患者中,男性37例(77.08%),女性11例(22.92%)。CYP2C9和VKORC1检出3种基因型,分别是*1*1/AA、*1*1/GA和*1*3/AA,其占比分别为66.67%、18.75%和14.58%。48例患者中有17例患者服用了华法林,其中13例患者在规定时间内检测了INR值。按华法林公益网站推荐的给药剂量服用华法林患者,INR值达标率明显高于未按推荐剂量服用华法林患者。结论临床还需加强宣传力度强化正确的基因检测意识,实现华法林个体化给药。

AIM To investigate the application value of CYP2C9 and VKORC1 genotypes detection for the guidance of individualized medication of warfarin. METHODS A total of 48 patients were selected for CYP2C9 and VKORC1 genotype detection in our hospital during the period from January 2016 to August 2018. The proportion of patients with genotypes was analyzed and the patients’ warfarin dose and international normalized ratio(INR)values were also analyzed. RESULTS Of the 48 patients, 37(77.08%) were males and 11(22.92%) were females. The genotypes of CYP2C9 and VKORC1 detected in drug genetic testing and research laboratory in our hospital were:*1*1/AA,*1*1/GA and *1*3/AA,which accounted for 66.67%, 18.75% and 14.85% respectively. The 17 patients received warfarin therapy and 13 patients of them were detected INR values within the specified time. The INR value compliance rate of patients who took warfarin according to genotype-based recommended dose were significantly higher than that of the patients who didn’t take the recommended dose of warfarin. CONCLUSION Clinically, there is a need to strengthen publicity efforts to enhance awareness of genetic testing and to realize individualized use of warfarin.