CYP4F2、CYP2C9和VKORC1基因多态性对中国汉族非瓣膜性房颤患者使用华法林剂量的影响  

Effects of CYP4F2,CYP2C9 and VKORC1 Genetic Polymorphisms on Maintenance Dosage of Warfarin in Chinese Han Nationality Patients with Non-valve Atrial Fibrillation

作　　者：朱君荣[1] 魏萌[2] 朱余兵[1] 谢渡江[1] 于锋[2] 叶飞[1] 陶宜富[1] 

机构地区：[1]南京医科大学附属南京医院,南京210006 [2]中国药科大学临床药学教研室,南京210009

出　　处：《中国药房》2012年第44期4161-4164,共4页China Pharmacy

基　　金：南京药学会-常州四药医院药学科研基金暨南京市科技发展计划(药学项目)(2011YX002)

摘　　要：目的:探讨CYP4F2等基因多态性及临床特征对中国汉族非瓣膜性房颤患者华法林剂量的影响。方法:采用连接酶检测反应(LDR)检测CYP2C9*3、VKORC11173和CYP4F2的基因型。多元线性回归分析CYP4F2等基因多态性及临床特征对中国汉族非瓣膜性房颤患者华法林剂量个体差异的影响。结果:CYP4F2TT患者的华法林剂量显著高于野生型患者([3.04±0.98)mgvs.(2.60±0.84)mg,P=0.034)];CYP2C9*3、VKORC11173和CYP4F2的基因多态性、年龄、体重、血栓史、联合应用胺碘酮以及β受体阻滞药解释了51.7%的华法林剂量个体差异,其中CYP4F2的基因多态性的贡献率为4.8%。结论:CYP4F2的基因多态性对中国汉族非瓣膜性房颤患者的华法林剂量有显著影响;基于临床特征与基因多态性的个体化给药方案可能有助于进一步提高非瓣膜性房颤患者的抗凝安全性。OBJECTIVE：To investigate the effect of gene polymorphism,including the CYP4F2,and clinical factors on the dose of warfarin in Chinese Han nationality with non-valve atrial fibrillation（NVAF）.METHODS：CYP2C9＊3,VKORC1 1173 and CYP4F2 were genotyped by using the ligase detection reaction（LDR） method.Multiple linear regression analysis was used to investigate the effects of gene polymorphism of CYP4F2 and clinical factors on the individual dose of warfarin.RESULTS：The CYP4F2 TT group took a significantly higher dose of warfarin（3.04±0.98） mg than wild-type group [（2.60±0.84） mg,P=0.034].Gene polymorphisms of CYP2C9＊3,VKORC1 1173 and CYP4F2,age,body weight,previous thromboembolism,amiodarone and β-blockers explained 51.7% of the variance in dose of warfarin.CYP4F2 contributed about 4.8% to the variance in the dose of warfarin.CONCLUSION：Gene polymorphism of CYP4F2 is a significant factor of individual variability in the dose of warfarin in Chinese Han patients with NVAF.The individual dosing regimens might improve the safety of warfarin therapy for NVAF patients based on clinical factors and gene polymorphism.

关 键 词：华法林 非瓣膜性房颤 细胞色素P450酶4F2 基因多态性 中国人 汉族 

分 类 号：R541.75[医药卫生—心血管疾病]