山东医药2016，Vol.56Issue(11)：14-17,4.DOI:10.3969/j.issn.1002-266X.2016.11.005
基于房颤患者CYP2C9和VKORC1基因型、年龄、身高建立并评价华法林给药剂量计算公式
Warfarin-dosing algorithm based on CYP2 C9 and VKORC1 genotypes, age and height of patients with atrial fibrillation
摘要
Abstract
Objective To develop and evaluate the warfarin-dosing algorithm based on cytochrome P 4502 C9 (CYP2C9) and vitamin K epoxide reductase complex 1 (VKORC1) genotypes, age and height of patients with atrial fibril-lation (AF).Methods A total of 122 AF patients were included and their genotypes of CYP2C9 (rs1057910) and VKORC1 (rs9923231) were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Multiple linear regression was performed to develop a warfarin dosing algorithm which was based on age , height, CYP2C9 and VKORC1 genotypes of AF patients .Another 60 AF patients were enrolled and randomly assigned into the con-trol group (n=30) and experimental group (n=30) .The experimental group received warfarin of "predicted warfarin dose"based on warfarin dosing algorithm , and the control group received warfarin of 2.5 mg/d.Both groups received war-farin for 7 days and then were adjusted to INR until reaching the stable warfarin maintenance dose .The time to reach a sta-ble warfarin maintenance dose was compared between the control group and experimental group .Results The warfarin-do-sing=0.438-0.0143 ×age+0.0149 ×height-0.324 ×CYP2C9 ×3+0.209 ×VKORC1, R2 =0.564.During the 50 day follow-up, there were 26 patients in the control group and 19 patients in the experimental group who acquired warfarin maintenance dose, with significant difference (P＜0.05).The mean time from initiation to warfarin maintenance dose was significantly shorted in the experimental group (25.8 ±1.7 d) than that in the control group (33.1 ±1.9 d), P＜0.05. Conclusion A new warfarin-dosing algorithm is developed based on CYP 2C9 and VKORC1 genotypes, age and height and it can shorten the time from initiation to warfarin maintenance dose in AF patients with warfarin therapy .关键词
心房颤动/华法林/细胞色素P4502C9/维生素K环氧化物还原酶复合体1/单核苷酸多态性Key words
atrial fibrillation/warfarin/cytochrome P4502C9/vitamin K epoxide reductase complex 1/single nucle-otide polymorphisms分类
医药卫生引用本文复制引用
蒋年新,葛俊炜,鲜玉琼,黄少鹰,李岩松..基于房颤患者CYP2C9和VKORC1基因型、年龄、身高建立并评价华法林给药剂量计算公式[J].山东医药,2016,56(11):14-17,4.基金项目
上海浦东新区卫计委课题(PW2013A-24) （PW2013A-24）
上海市第七人民医院人才培养计划项目(XX2013-001). （XX2013-001）
