实用医学杂志2017，Vol.33Issue(7)：1120-1123,4.DOI:10.3969/j.issn.1006-5725.2017.07.027
CYP2C9和CYP4F2基因多态性对瓣膜置换术后华法林维持剂量的影响
Influence of CYP2C9 and CYP4F2 gene polymorphisms on stable warfarin dose after cardiac valve replacement
摘要
Abstract
Objective To evaluate the influence of cytochrome P450 (CYP2C9 and CYP4F2) polymorphisms on anticoagulant intensity of warfarin after cardiac valve replacement.Methods A total of 136 patients tak ing warfarin after cardiac valve replacement were identified and classified into 4 groups:CYP2C9 wild type group (CYP2C9*1*1),CYP2C9 mutated type group (CYP2C9*3),CYP4F2 rs2108622 wild type group (CC) and CYP4F2 rs2108622 mutated type group (CT or TT).The patients' baseline data,initial dose of warfarin and base INR measurement resuhs were recorded and then the follow-up was conducted.The initial administration of warfarin to INR standard time for the first time,total amount of warfarin and the average daily amount were recorded.Results Patients carrying CYP2C9* 1* 1 had increased time to reach INR target value for the first time (P ＜ 0.05);and the total warfarin doses and average daily dose when INR reached target value were higher than those carrying CYP2C9*3 (P ＜ 0.05).When compared with those in two wild type groups,patients carrying CYP2C9 and CYP4F2 rs2108622 mutated type needed the shortest time when INR reached target value for the first time,and the total warfarin doses and average daily dose when INR first reached target value was the lowest,which showed significant difference (P ＜ 0.05).And when compared with CYP2C9 mutated type group,the INR average time to reach the first target was shortened and the total warfarin dose of patients carrying CYP2C9 and CYP4F2 rs2108622 mutated type was lower (P ＜ 0.05).Conclusion The gene polymorphisms of CYP2C9 and CYP4F2 are significant hereditary factors influencing warfarin dose.Detection of CYP2C9 and CYP4F2 genotypes prior to medication and predicating warfarin dosage may result in lower incidence of over-anticoagulation and reduce the dosage-adjusting time of warfarin.关键词
瓣膜置换/华法林/细胞色素P450酶/基因多态性Key words
Valve replacement/Warfarin/Cytochrome P450/Gene polymorphism引用本文复制引用
马建新,董兵,马建慧,李胜萍,刘学..CYP2C9和CYP4F2基因多态性对瓣膜置换术后华法林维持剂量的影响[J].实用医学杂志,2017,33(7):1120-1123,4.基金项目
解放军305医院重点科研基金项目(编号:12YA01) （编号:12YA01）
