不同民族心房颤动患者CYP2 C9*3和VKORC1基因多态性与华法林用药量关联性研究

Association of CYP2C9*3 and VKORC1 gene polymorphisms with warfarin dosage in patients with atrial fibrillation of different nationalities

目的探讨不同民族心房颤动患者CYP2C9*3(1075A>C)和VKORC1(1639G>A)基因多态性与华法林用药量的关联。方法收集新疆喀什地区第一人民医院2016-01-01-2020-01-01收治的汉族房颤患者80例及维吾尔族房颤患者40例为研究对象。采用基因测序的方法检测CYP2C9*3(1075A>C)和VKORC1(1639G>A)基因型分布,应用IWPC公式预测不同民族房颤患者华法林的剂量。结果维吾尔族与汉族组CYP2C9*3(1075A>C)等位基因分布,差异有统计学意义,χ^(2)=5.486,P<0.05;其中,汉族组AA型高于维吾尔族组,AC(或CC)型低于维吾尔族组。维吾尔族与汉族组VKORC1(1639G>A)等位基因分布,差异有统计学意义,χ^(2)=27.610,P<0.001;其中,汉族组AA型高于维吾尔族组,AG(或GG)低于维吾尔族组。IWPC法计算出维吾尔族患者平均华法林维持剂量为(4.82±1.47)mg/d,汉族患者为(3.53±0.98)mg/d,维吾尔族组华法林所需要剂量高于汉族组,χ^(2)=5.718,P<0.001。结论不同民族CYP2C9*3(1075A>C)及VKORC1(1639G>A)基因多态性不同,且其对华法林用药量有影响。

Objective Objective Discussion of CYP2C9*3(1075 A>C)and VKORC1(1639 G>A)Association between gene polymorphism and warfarin dosage in patients with atrial fibrillation of different ethnic groups.Methods A total of 80 patients with atrial fibrillation of the Han nationality and 40 patients with atrial fibrillation of the Uygur nationality admitted to the First People’s Hospital of Kashgar District of Xinjiang from January 1,2016 to January 1,2020 were collected.CYP2C9*3(1075 A>C)and VKORC1(1639 G>A)Genotype distribution,and IWPC formula was used to predict warfarin dose in patients with atrial fibrillation of different ethnic groups.Results Uygur and Han group CYP2C9*3(1075 A>C)There was significant difference in allele distribution(χ^(2)=5.486,P<0.05),AA type in Han group was higher than that in Uygur group,and AC(or CC)type was lower than that in Uygur group.The polymorphism of VKORC1 gene in the uygur and han groups was statistically significant(χ^(2)=27.610,P<0.001),and the AA type in the han group was higher than that in the uygur group.AG(or GG)was lower than uygur group.According to IWPC method,the average warfarin maintenance dose of uygur patients was(4.82±1.47)mg/d,and that of han patients was(3.53±0.98)mg/d,in uygur group higher than in han group(χ^(2)=5.718,P<0.001).Conclusion Different ethnic groups have different genetic polymorphisms CYP2C9*3(1075 A>C)and VKORC1(1639 G>A),and their warfarin dosage has influence.