心房颤动患者CYP2C9、VKORC1基因多态性与华法林药物敏感度的关系

The Relationship between Warfarin Drug Sensitivity and Polymorphisms of CYP2C9 and VKORC1 Genes in Patients with Atrial Fibrillation

目的分析心房颤动(AF)患者CYP2C9、VKORC1基因多态性与华法林药物敏感度的关系。方法根据华法林给药累计剂量,将27例AF患者分为低起效剂量组和高起效剂量组;根据达标时间,分为短起效时间组和长起效时间组。比较高、低起效剂量组和长、短起效时间组CYP2C9、VKORC1不同基因型华法林的起效剂量和起效时间。结果高、低起效剂量组rs1057910(CYP2C9*3)及长、短起效时间组VKORC1 rs9923231基因构成差异有统计学意义(P<0.05)。与AA基因型比较,CYP2C9 rs1057910 AC基因型华法林起效剂量降低,VKORC1 rs9923231 GA基因型华法林起效时间缩短(P<0.05)。华法林药物敏感度可分为低度敏感、中度敏感和高度敏感3种。结论应结合临床实际对口服华法林行抗凝治疗的AF患者进行CYP2C9、VKORC1基因多态性检测,以便从基因类型角度合理分配华法林剂量。

OBJECTIVE To analyze the relationship between CYP2C9 and VKORC1 gene polymorphisms and warfarin drug sensitivity in patients with atrial fibrillation(AF).METHODS Twenty-seven patients with persistent non-valvular AF who underwent anticoagulant therapy were enrolled;The patients were divided into low-acting dose group and high-effect dose group;According to the time of arrival,the patients were divided into short-acting time group and long-acting time group.RESULTS There were significant differences in the composition of CYP2C9*3 between the high and low onset dose and in the composition of VKORC1 between the long and short onset time groups(P<0.05).Due to the different genotypes of CYP2C9 and VKORC1,warfarin drug sensitivity can be divided into three types:low sensitivity,moderate sensitivity and high sensitivity.CONCLUSION In combination with clinical practice,the CYP2C9 and VKORC1 gene polymorphisms in AF patients who received anticoagulant therapy with oral warfarin may help to rationally distribute warfarin dose from the perspective of gene type.