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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

23卷

期数:

2017年06期

页码:

525-529

栏目:

临床医学

出版日期:

2017-11-20

文章信息/Info

Title:

Study on prediction model of stable dosage of warfarin after valve replacement

文章编号:

1006-8147(2017)06-0525-05

作者:

戴健行¹; 白云鹏²; 陈庆良²; 毛用敏³; 刘建实²

（1.天津医科大学研究生院，天津 300070；2.天津市胸科医院心脏外科，天津300350；3.天津市胸科医院心血管病研究所，天津 300350）

Author(s):

DAI Jian-xing¹;  BAI Yun-peng²;  CHEN Qing-liang²; MAO Yong-min³;  LIU Jian-shi²

（1. Graduate School，Tianjin Medical University，Tianjin 300070, China;2.Department of Cardiology, Tianjin Chest Hospital, Tianjin 300000, China; 3. Institute of Cardiovascular Diseases, Tianjin Chest Hospital, Tianjin 300000, China）

关键词:

华法林;  基因多态性;  临床因素; 人口学因素

Keywords:

warfarin; gene polymorphism; clinical factors; demographic factors

分类号:

R969.3

DOI:

-

文献标志码:

A

摘要:

目的：研究瓣膜置换术后CYP2C9*2、CYP2C9*3、CYP4F2、GGCX、VKORC1-1173、VKORC1-1639基因多态性，及人口学、临床因素对瓣膜置换术后华法林稳定剂量的影响，建立华法林稳定剂量的预测模型。方法：收集226例瓣膜置换患者，提取DNA，设计引物，应用聚合酶链式反应（PCR）技术扩增上述位点基因，应用酶切技术，以特定内切酶切出相关基因，以电泳显示最终结果，得出目标DNA基因序列，回顾追踪患者服药剂量、临床资料、人口学特征，并长期监测其INR,结合有无出血、血栓形成，得出瓣膜置换术后华法林稳定剂量预测模型。结果：得出华法林稳定剂量预测模型：Y=2.131-1.816VKORC1-1173+0.369GGCX+1.529BSA-0.013Age(V1173当基因型为AA型时，取1，非AA型取0，当GGCX为GT型时取1，非GT型取0，BSA单位为㎡，Age单位为岁)。华法林稳定剂量与体表面积、年龄、VKORC1-1173、GGCX基因型相关，与CYP2C9*2、CYP2C9*3、CYP4F2、VKORC1-1639无明显线性关系。结论： VKORC1-1173的AA基因型与年龄与华法林稳定剂量呈负相关，而GGCX的GT基因型与体表面积与华法林稳定剂量呈正相关。

Abstract:

Objective ：To study the effects of CYP2C9*2, CYP2C9*3,CYP4F2, GGCX, VKORC1-1173, VKORC1-1639 gene polymorphisms and the effects of demographic and clinical factors on the stable dose of warfarin after valve replacement, and to establish a prediction model of stable dose of warfarin. Methods: From October 15, 2012 to December 20, 2014, 226 patients with valve replacement were enrolled in this study.Extract DNA, Primers were designed and amplified by polymerase chain reaction (PCR) and the endogenous gene was digested with specific endonuclease. The specific results were obtained by electrophoresis. The target DNA gene sequence was obtained. The patient’s dose, clinical data and demographic characteristics and the INR were tracked. With or without presence bleeding and thrombosis, we inferred warfarin stable dose prediction model after valve replacement. Results: The prediction model of warfarin was obtained：Y = 2.131-1.816V1173+ 0.369GGCX + 1.529BSA-0.013Age (VKORC1-1173 When the genotype is AA type, take 1, non-AA to take 0, when GGCX for the GT type 1, non-GT take 0，BSA unit is ㎡, Age unit is year). The stable dose of warfarin was not strongly correlated with the expression of CYP2C9 * 2, CYP2C9 * 3, CYP4F2 and VKORC1-1639, and was related to the body surface area, age, VKORC1-1173 and GGCX genotype.Conclusion:The AA genotype of VKORC1-1173 and age could be negatively correlated with warfarin stable dose, while GT genotype of GGCX and BSA may have a positive correlation with the stable dose of warfarin.

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相似文献/References:

备注/Memo

备注/Memo:

作者简介戴健行（1991-），男，硕士在读，研究方向：心胸外科；通信作者：刘建实，E-mail: liujianshi135@163.com。

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更新日期/Last Update: 2017-11-14