CYP2C9和VKORC1基因多态性对华法林抗凝疗效的影响

中国药物评价 ›› 2021, Vol. 38 ›› Issue (1): 25-29.

CYP2C9和VKORC1基因多态性对华法林抗凝疗效的影响

王威丽1，2，张阳2，李兴德2，毛盼盼2，张函舒2，宋沧桑1，2*

1. 大理大学药学院，云南大理 671000
2. 昆明市第一人民医院药学部，云南昆明 650000

收稿日期:2021-01-19 修回日期:2021-02-19 出版日期:2021-02-28 发布日期:2021-02-28
基金资助:
临床药师参与精准药学服务在华法林抗凝治疗中的作用研究（项目编号：2018NS0169）

Influence of CYP2C9 and VKORC1 Gene Polymorphisms on the Anticoagulant Efficacy of Warfarin

1. Dali University College of Pharmacy， Yunnan Dali 671000， China；
2. Kunming First People′s Hospital Department of Pharmacy， Yunnan Kunming 650000， China

Received:2021-01-19 Revised:2021-02-19 Online:2021-02-28 Published:2021-02-28
Contact: Sang CangSONG E-mail:songcs163@163.com

摘要/Abstract

摘要： 目的：分析探讨CYP2C9和VKORC1基因多态性对华法林抗凝疗效的影响，为进一步指导临床精准合理化用药提供参考。方法：通过医院电子病历系统收集昆明市某三甲医院2019年1月至2020年9月住院期间患者服用华法林抗凝治疗的184例临床信息，并根据是否进行CYP2C9 (1075A>C)、VKORC1 (1639 G>A) 基因检测分为个体化用药组 (试验组) 和传统给药组 (对照组)，对比分析两组患者相关临床指标。结果：与对照组相比，试验组国际化标准比值( International normalized ratio，INR) >4的例数、维生素K1使用例数明显减少 (P<0.05)。两组间华法林相关出血例数、INR平均检测次数、平均住院时间差异无统计学意义 (P>0.05)。结论：根据CYP2C9和VKORC1基因检测指导华法林个体化用药，能够提高患者的抗凝疗效，减少不良反应的发生风险，保障华法林治疗的有效性及安全性。

关键词: font-size:medium, ">华法林；CYP2C9；VKORC1；基因多态性；合理用药

Abstract: Objective： To analyze and explore the effect of CYP2C9 and VKORC1 gene polymorphism on warfarin anticoagulant effect， and to provide reference for further guidance of clinical accurate and rational drug use. Methods：The clinical information of 184 patients who took warfarin anticoagulant therapy from January 2019 to September 2020 in a third class hospital in Kunming was collected through the hospital electronic medical record system， and based on whether to CYP2C9(1075A>C)、VKORC1(1639G>A) gene detection was divided into individualized medication group (test group) and traditional administration group (control group)， and comparative analysis of relevant clinical indicators of the two groups of patients. Results：Compared with the control group， the number of cases with international normalized ratio (INR)> 4 and the number of vitamin K1 use cases in the test group were significantly reduced (P<0.05). However， there was no significant difference in the number of warfarin-related bleeding cases， the average number of INR tests， and the average length of stay between the two groups (P>0.05). Conclusion：The individualized medication of warfarin according to CYP2C9 and VKORC1 gene detection can improve the anticoagulant effect of patients， reduce the risk of adverse reactions， and ensure the effectiveness and safety of warfarin therapy.

Key words: font-size:medium, ">Warfarin； CYP2C9； VKORC1； Polymorphisms； Rational drug use

中图分类号:

王威丽, 张阳, 李兴德, 毛盼盼, 张函舒, 宋沧桑, . CYP2C9和VKORC1基因多态性对华法林抗凝疗效的影响[J]. 中国药物评价, 2021, 38(1): 25-29.

WANG Wei-li, ZHANG Yang, LI Xing-de, MAO Pan-pan, ZHANG Han-shu, SONG Cang-sang, . Influence of CYP2C9 and VKORC1 Gene Polymorphisms on the Anticoagulant Efficacy of Warfarin[J]. CHINESE JOURNAL OF DRUG EVALUATION, 2021, 38(1): 25-29.

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