基因多态性对华法林低强度抗凝治疗稳定剂量影响的前瞻性研究

被引：7

作者：

许强

尹彤

机构：

[1] 中国人民解放军总医院老年心血管病研究所

来源：

中国循证心血管医学杂志 | 2013年 / 5卷 / 02期

关键词：

华法林; 低强度抗凝; 基因多态性;

D O I：

暂无

中图分类号：

R541.75 [];

学科分类号：

1002 ; 100201 ;

摘要：

目的对影响华法林代谢及作用的多个相关基因进行测定,探讨其对中国人群低强度华法林抗凝稳定剂量的影响程度。方法共纳入170名拟采取低强度华法林抗凝治疗患者,对其与华法林代谢及作用相关的3个基因CYP2C9(rs1057910)、VKORC1(rs9923231)、CYP4F2(rs2108622)位点的基因多态性(SNP)进行检测,随后给予华法林治疗,目标国际标准化比值(INR)1.8～2.5,观察90天,同时记录患者的临床因素、INR值及华法林稳定剂量,分别判断临床及基因因素对华法林稳定剂量水平的影响作用。结果 CYP2C9、VKORC1、CYP4F2的5个SNP位点的SNP对华法林稳定剂量存在显著影响(P<0.05)。经多元回归分析,年龄、体表面积、抗凝第4天INR值以及CYP2C9、VKORC1、CYP4F2的SNP是华法林抗凝稳定剂量的独立影响因素;其中SNP可以独立解释18.6%的华法林稳定剂量的差异。结论在目标强度为INR1.8～2.5的低强度华法林抗凝治疗中,CYP2C9(rs1057910)、VKORC1(rs9923231)、CYP4F2(rs2108622)多态性对稳定剂量存在显著影响,可在临床工作中对上述3个SNP位点进行检测,对抗凝初期华法林的剂量进行预先调整。

引用

页码：127 / 129

页数：3

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