CYP2C9、VKORC1基因多态性与华法林个体化用药研究进展  

Research progress in CYP2C9 and VKORC1 gene polymorphism and individualized warfarin therapeutic regimen

作　　者：刘跃平[1] 杨翔[1] 徐含青 李永川[1] 李明[2] 黄庆[1] 府伟灵[1] 

机构地区：[1]第三军医大学西南医院检验科,重庆400038 [2]解放军477医院检验科,湖北襄阳441000

出　　处：《解放军医学杂志》2015年第2期163-168,共6页Medical Journal of Chinese People's Liberation Army

摘　　要：尽管具有治疗指数狭窄和出血并发症频繁的弊病,华法林仍是临床上应用非常广泛的口服抗凝血药物。不同患者对华法林的反应差异很大,在达到相同治疗效果的情况下,不同个体的用药剂量可能相差20倍之多。华法林的治疗剂量受多种因素影响,包括基因多态性、体重指数、年龄等及其他药物因素等,这就要求临床医师在应用华法林时需注重个体化用药及选择最优治疗方案。多种基因可影响华法林的药物代谢,其中细胞色素P450 2C9(CYP2C9)及维生素K环氧化物还原酶复合体1(VKORC1)基因多态性是目前研究的重点。本文将综述以上两个基因的基因多态性及其与华法林个体化用药相关性的研究进展。Warfarin is still the most clinically used oral anti-coagulant despite of its narrow therapeutic index and high risk of hemorrhage. The mean daily dose of warfarin varies widely from patient to patient, and to achieve the same therapeutic effect, the daily dose of warfarin could be varied over 20-fold. The variability in warfarin dosage depends on several factors, including gene polymorphisms, index of body mass, age and other drugs, and these factors compelled the clinicians to individualize warfarin dosage in order to optimize the therapeutic regimen. A number of genes are involved in metabolism of warfarin, such as cytochrome P450 2C9 （CYP2C9）, vitamin K epoxide reductase complex subunit 1 （VKORC1）, cytochrome P4S0 4F2 （CYP4F2）, gamma-glutamylcarboxylase （GGCX）, etc. Of them CYP2C9 and VKORC 1 are the emphasis of current researches. The association between the polymorphism of CYP2C9 and VKORC 1 and individualized warfarin therapeutic regimen are mainly discussed in this paper.

关 键 词：细胞色素P450 CYP2C9 维生素K环氧化物还原酶复合体1 遗传药理学 华法林 个体化医学 多态性 单核苷酸 

分 类 号：R973.2[医药卫生—药品]