新疆汉族和维吾尔族机械瓣膜置换术后低强度抗凝条件下华法林维持剂量与CYP2C9和VKORC1基因多态性的相关性研究  

Correlation between warfarin maintainance dose with the polymorphisms of CYP2C9 and VKORC1 in Han and Uygur population on low anticoagulant level after mechanical heart valve prostheses implantation

作　　者：唐和年[1] 杜宇奎[1] 张总刚[1] 郭永忠[1] 阿不拉江[1] 郭盛[1] 马中原[1] 阿依别克[1] 刘军[1] 李明[1] 

机构地区：[1]新疆维吾尔自治区人民医院心脏外科,乌鲁木齐830001

出　　处：《中国医药》2007年第4期216-220,共5页China Medicine

基　　金：新疆维吾尔自治区科技攻关和重大科技项目（200233118）

摘　　要：目的探讨性别、年龄、体重、体质指数、瓣膜置换部位以及CYP2C9和VKORC1基因多态性对机械瓣膜瓣膜置换术后个体华法林维持剂量的影响。方法瓣膜置换术后个体根据国际化标准比值（INR）1.5～2.0调整华法林维持剂量,采用PCR-RFLP技术对37例汉族和51例维吾尔族（维族）换瓣个体以及205例和204例汉族健康对照人群和维族体检健康对照人群进行CYP2C9和VKORC1基因多态性检测。结果汉族换瓣个体华法林维持剂量（2.47±0.73）mg,低于维族换瓣个体华法林维持剂量（3.00±0.99）mg,二者比较差异有统计学意义（P〈0.01）。性别、年龄、体重、体质指数、瓣膜置换部位对换瓣个体华法林维持剂量影响无统计学意义（R2=0,P〉0.05）。VKORC1和CYP2C9基因多态性对华法林维持剂量影响有统计学意义（R2值分别为0.381和0.169,P〈0.01）。结论VKORC1基因多态性是个体之间华法林维持剂量出现差异的主要因素,也是民族之间华法林维持剂量出现差异的主要因素。Objective To investigate the correlation between warfarin maintainance dose with sex, age, weight,BMl,plaees in which mechanical heart valve prostheses was implanted and the polymorphisms of CYP2C9 and VKORC1 in Han and Uygur subjects on low anticoagulant level. Methods Warfarin maintain dose was adjus- ted to INR （ 1.5 - 2.0 ）. The polymorphisms of CYP2C9 and VKORC1 were detected by using PCR-RFLP method in 37 Han and 51 Uygur subjects with operated mechanical heart valve prostheses implantation as well as 205 Han and 204 Uygur healthy subjects as control group. Results Warfarin maintain dose （2.47 ± 0.73 ） mg of Han was lower than that （ 3.00± 0.99 ） mg of Uygur population （ P 〈 0.01 ）. Sex, age, weight, BMI and places in which mechanical heart valve prostheses were implanted had no significant influence on the wafarin maintain dose （R2 = 0, P 〉 0.05 ）. The effects of polymorphisms of VKORC1 and CYP2C9 were significant （ R^2 0.381 and 0.169 for each, P 〈 0.01 ）. Conlusion Polymorphism of VKORCI is dominant factor causing warfarin maintain dose different between subjects as well as nationalities.

关 键 词：机械瓣膜置换术 CYP2C9 VKORC1 基因多态性 汉族 维吾尔族 

分 类 号：R544.1[医药卫生—心血管疾病]