摘要
目的:研究回顾性探讨CYP2C9和VKORC1基因检测能否为华法林抗凝治疗患者带来临床获益,为临床应用华法林基因检测提供参考。方法:在这项回顾性研究中,收集了昆明市某三甲医院2016年1月至2017年9月间服用华法林抗凝治疗的住院患者信息。根据CYP2C9和VKORC1基因检测指导分为华法林个体化用药组(试验组)和传统给药组(对照组),对比分析2组患者的临床结局。结果:试验组患者国际标准化比值(INR)>4例数、维生素K使用例数以及INR平均检测数均显著小于对照组。两组患者平均住院时间、华法林相关出血例数、出院时的INR值差异均无显著性意义。结论:采用CYP2C9和VKORC1基因检测指导华法林用药代替传统给药可以降低患者不良事件的发生风险,同时也可以减少患者监测INR的次数,具有良好的临床效果。因此,推荐临床上在应用华法林之前进行CYP2C9和VKORC1基因检测。
OBJECTIVE To retrospectively investigate whether CYP2C9 and VKORC1 gene detection can bring clinical benefits to patients with warfarin anticoagulation therapy and provide a reference for clinical application of warfarin gene detection.METHODS In this retrospective study,the information of inpatients who took warfarin anticoagulation therapy from January 2016 to September 2017 in a tertiary care hospital in Kunming was collected.According to the guidance of CYP2C9 and VKORC1 gene detection,the patients were divided into warfarin individualized medication group(test group)and traditional administration group(control group),and the clinical outcomes of the two groups were compared and analyzed.RESULTS The number of cases with international normalized ratio(INR)>4,the number of cases with vitamin K use and the average number of INR tests in the test group were significantly smaller than those in the control group.However,there were no significant differences in the average length of hospital stay,the number of warfarin-related bleeding,and INR values at discharge between the 2 groups.CONCLUSION The use ofCYP2C9 andVKORC1 gene detection to guide warfarin to replace traditional administration can reduce the risk of adverse events in patients while reducing the number of monitoring of INR in patients,which has a good clinical effect.therefore,it is recommended to perform CYP2C9 and VKORC1 gene detection before the application of warfarin in clinical practice.
作者
张阳
宋沧桑
王威丽
宋文彬
毛盼盼
ZHANG Yang;SONG Cang-sang;WANG Wei-li;SONG Wen-bin;MAO Pan-pan(First Affiliated Hospital of Kunming College,Yunnan Kunming 650000,China;Dali University College of Pharmacy and Chemistry,Yunnan Dali 671000,China)
出处
《中国医院药学杂志》
CAS
北大核心
2020年第10期1140-1144,共5页
Chinese Journal of Hospital Pharmacy
基金
昆明学院2017年度校级科研项目(编号:XJZD1705)。
