摘要
目的:研究CYP2C9及VKORC1基因多态性检测指导心脏瓣膜患者术后抗凝治疗的临床价值。方法:回顾性分析2014年3月至2017年7月我院收治的心脏瓣膜疾病患者,选择进行CYP2C9及VKORC1基因多态性检测的95例患者作为研究组,选择未开展检测的95例患者作为对照组。观察研究组患者的CYP2C9及VKORC1基因型,比较不同基因型患者的华法林用量、国际标准化比值(INR)达标时间;比较研究组与对照组患者INR达标时间。结果:研究组中85例患者为中CYP2C9^(*)1/^(*)1型,9例CYP2C9^(*)1/^(*)3型,1例CYP2C9^(*)3/^(*)3型;77例VKORC1 AA型,18例VKORC1 AG型,无VKORC1 GG型。研究组中CYP2C9^(*)1/^(*)1型患者较CYP2C9^(*)1/^(*)3型患者的华法林实际服用剂量更高,INR达标时间更短,差异均有显著性(P<0.05);VKORC1 AA型患者较VKORC1 AG型患者的华法林实际服用剂量更低,INR达标时间更短,差异均有显著性(P<0.05)。研究组较对照组INR达标时间更短,差异有统计学意义(P<0.05);结论:心脏瓣膜患者术后抗凝治疗中CYP2C9及VKORC1基因多态性检测对初期治疗方案制定、调整具有重要作用,可为早期临床方案制定提供重要参考依据。
Objective:To study the clinical value of CYP2C9 and VKORC1 gene polymorphisms in guiding postoperative anticoagulation therapy in patients with heart valves.Methods:A retrospective analysis was performed on AIS patients admitted to our hospital from March 2014 to July 2017.95 patients undergoing CYP2C9 and VKORC1 gene polymorphism detection were selected as the study group,and 95 patients without detection were selected as the control group.The CYP2C9 and VKORC1 genotypes of the patients in the study group were observed,the warfarin dosage and the international normalized ratio(INR)compliance time of the patients with different genotypes were compared,and the INR compliance time of the study group and the control group were compared.Results:In the study group,85 patients were of CYP2C9^(*)1/^(*)1 type,9 were of CYP2C9^(*)1/^(*)3 type,1 was of CYP2C9^(*)3/^(*)3 type;77 were of VKORC1 type AA,18 were of VKORC1 AG type,VKORC1 GG type was not found.In the study group,patients with CYP2C9^(*)1/^(*)1 type had a higher actual dose of warfarin than CYP2C9^(*)1/^(*)3 patients,and the time for INR to reach the standard was shorter,and the difference was significant(P<0.05);patients of VKORC1 AA type had lower actual dose of warfarin,compared with VKORC1 AG patients,and the INR compliance time was shorter,and the difference was significant(P<0.05).The study group had shorter INR compliance time than the control group,and the difference was significant(P<0.05).Conclusion:The detection of CYP2C9 and VKORC1 gene polymorphisms in the postoperative anticoagulation therapy of heart valve patients plays an important role in the formulation and adjustment of the initial treatment plan,and can provide an important reference for the early clinical plan formulation.
作者
林升雄
吴丹娜
曹一秋
LIN Shengxiong;WU Danna;CAO Yiqiu(Hainan Provincial People's Hospital, Hainan Haikou 570311, China)
出处
《河北医学》
CAS
2022年第2期292-295,共4页
Hebei Medicine
基金
海南省医药卫生科研项目,(编号:19A200055)。
