CYP2C9和VKORC1基因多态性与华法林个体化用药的临床研究  

Clinical research of gene polymorphism in CYP2C9 and VKORC1 and individualized medication of warfarin

作　　者：陈晖[1] 马蕾[1] 

机构地区：[1]郑州大学附属郑州中心医院,450007

出　　处：《中国实用医药》2015年第12期3-5,共3页China Practical Medicine

摘　　要：目的：探讨细胞色素P450同工酶2C9（CYP2C9）及维生素K环氧化物还原酶复合体亚单位1（VKORC1）基因多态性对华法林个体化用药的影响。方法110例临床初次和维持口服华法林抗凝治疗的患者，记录患者的年龄、性别、身高、体重和服用华法林5-7 d后每次国际标准化比值（INR）的测定值， INR达到目标值时华法林的总用量以及华法林的日均用量。同时检测CYP2C9＊1、＊2、＊3位点和VKORC1-1639 AA、AG、GG位点基因型。结果对于初次口服华法林的患者， CYP2C9＊2或＊3基因型患者在抗凝治疗初期易发生INR值超过治疗窗（INR〉3.0）；而VKORC1-1639 AG或GG基因型患者INR达标时间明显延长，并且INR达标时所服用的华法林总剂量和日均剂量均高于AA基因型患者。结论 CYP2C9和VKORC1基因检测对于指导患者华法林的个体化用药具有一定的临床意义。Objective To investigate the influence of gene polymorphism in cytochrome P450 isoenzyme 2C9 （CYP2C9） and vitamin K epoxide reductase complex subunit 1 （VKORC1） gene on individualized medication of warfarin.Methods There were 100 patients of clinical first administration and maintain oral administration of warfarin for anticoagulant therapy. Their age, gender, height, weight, international normalized ratio （INR） value after 5-7 d of administration, total amount of warfarin with standard INR value, and average daily amount of warfarin. Detection was also made on the gene types in CYP2C9 ＊1, ＊2, ＊3 and VKORC1-1639 AA, AG, GG.Results For patients with the first time administration of warfarin, their CYP2C9 ＊2 or ＊3 gene type were easily over therapeutic window of INR value in the beginning of anticoagulant therapy （INR〉3.0）. Patients with VKORC1-1639AG or GG gene type had longer INR standard time, and their total administration amount and average daily amount of warfarin were all higher than those with AA gene type.Conclusion CYP2C9 and VKORC1 gene detection has certain clinical significance for guiding individualized medication of warfarin.

关 键 词：华法林 个体化用药 基因多态性 细胞色素P450同工酶2C9 维生素K环氧化物还原酶复合体亚单位1 

分 类 号：R969[医药卫生—药理学]