【摘要】 目的探讨心脏瓣膜置换术后需长期口服华法林抗凝治疗的患者华法林维持剂量与细胞色素P4502C9(CYP2C9)基因CYP2C9*3(Ile359Leu)突变的关系。方法93例心脏瓣膜置换术后需长期口服华法林抗凝治疗患者根据国际标准化比值(INR)1.5~2.0调整华法林的用量,应用聚合酶链反应-限制性片段长度多态性分析方法(PCR-RFLP)检测CYP2C9*3的突变情况,根据有无突变进行分组,比较有突变组和无突变组患者每周华法林的维持剂量。结果93例口服华法林抗凝治疗患者中检测出CYP2C9*3突变的有14例,无突变的79例,突变组每周华法林维持剂量为(15.22±5.49)mg,无突变组每周华法林维持剂量为(19.83±5.99)mg,突变组华法林的维持剂量明显低于无突变组,两组间差别有统计学意义(t=2.686,P<0.05)。结论CYP2C9*3突变是不同个体间华法林维持剂量出现差异的主要原因之一,为了降低使用华法林时发生不良反应的风险,在口服华法林抗凝治疗时应检测CYP2C9*3的突变情况。更多还原

【Abstract】 Objective To study on the association between the maintenance dose of Warfarin anticoagulation therapy and the CYP2C9*3 (Ile359Leu) genetic mutation of cytochrome P450(CYP2C9) in patients with mechanical heart valve prosthesis and who needs Warfarin anticoagulant therapy for all life. Methods Warfarin maintenance dose was adjusted according to international normalized ratio(INR)1.5~2.0, the CYP2C9*3 (Ile359Leu) genetic mutation was analyzed in 93 patients with mechanical heart valve prostheses and who needed Warfarin anticoagulant therapy for all life by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Patients were assigned into two groups by the gene mutation and the weekly maintenance dose of Warfarin was compared between two groups. Results Of 93 patients, there were 14 patients with CYP2C9*3 mutation and 79 patients without CYP2C9*3 mutation. The weekly maintenance dose of Warfarin in mutation group [(15.22±5.49 )mg] was significantly higher than that in non-mutation group [(19.83±5.99)mg] (t=2.686,P<0.05). Conclusion The CYP2C9*3 mutation was one of the main factors for difference of Warfarin maintenance dose among different people. CYP2C9*3 mutation should be analyzed before using Warfarin anticoagulant therapy in order to decrease the risk of complications.更多还原