不同CYP2C9及GGCX基因型在人工瓣膜置换术后的抗凝效果比较

发布时间：2018-03-03 05:26

本文选题：CYPC基因型　切入点：GGCX基因型　出处：《中国现代医学杂志》2017年18期 　论文类型：期刊论文

【摘要】：目的了解不同CYP2C9及GGCX基因型对人工瓣膜置换术后抗凝效果的影响。方法选取2013年1月-2016年12月在该院心脏外科接受心脏瓣膜置换术的患者,采集服药后空腹12 h的外周静脉血3 ml进行CYP2C9和GGCX基因型检测,收集患者相关临床资料,采用SPSS 21.0软件进行数据分析。结果选取80例患者,CYP2C9基因型有2种,包括73例CYP2C9*1*1和7例CYP2C9*1*3患者;42例GGCX*A*G型和38例GGCX*G*G型患者。两种基因型患者在性别、年龄、体质指数(BMI)、凝血酶原时间(PT)、国家标准化比值(INR)值及达到稳定抗凝效果后的华法林血药浓度差异无统计学意义(P0.05),但CYP2C9*1*1型患者INR首次达标时间CYP2C9*1*3型患者(P=0.013),CYP2C9*1*1型患者华法林日均稳定维持剂量CYP2C9*1*3型患者(P=0.011),GGCX*A*G型患者华法林日均稳定维持剂量GGCX*G*G型患者(P=0.000),同时为CYP2C9*1*1型和GGCX*A*G型的患者华法林日均稳定维持剂量其他3组(P=0.024)。CYP2C9基因型(P=0.001)和GGCX基因型是影响患者术后第6天是否能达到治疗窗的影响因素(P=0.032)。结论根据CYP2C9基因型和GGCX基因型确定个人使用剂量,可提高患者抗凝治疗效果。
[Abstract]:Objective to investigate the effect of different CYP2C9 and GGCX genotypes on the anticoagulant effect after prosthetic valve replacement. CYP2C9 and GGCX genotypes were detected with 3 ml peripheral venous blood 12 h after taking the drug. The data were analyzed by SPSS 21.0 software. Results there were 2 genotypes of CYP2C9 in 80 patients. There were 73 cases of CYP2C9*1*1 and 7 cases of CYP2C9*1*3, 42 cases of GGCX*A*G and 38 cases of GGCX*G*G. There was no significant difference in body mass index (BMI), prothrombin time (PTT), national standardized ratio (INR) and warfarin concentration after stable anticoagulant effect (P 0.05), but the first time for INR in CYP2C9*1*1 patients was the first time for INR to be up to standard. The mean daily maintenance dose of warfarin in patients with CYP2C9*1*3 type and CYP2C9*1*1 type and GGCX*A*G type is P0. 024. CYP2C9 genotype P0. 001) and GGCX genotype is 0. 001) and 0. 000g / d in patients with GGCX*G*G type and GGCX*A*G type respectively. The mean daily maintenance dose of warfarin is 0. 011%, P0. 001) and that of CYP2C9*1*1 type and GGCX*A*G type is 0. 024% and 0. 024%. CYP2C9 genotype P0. 001) and GGCX genotype respectively. On the 6th day after operation, the factors affecting whether the patients could reach the therapeutic window were determined. Conclusion the individual dosage of CYP2C9 and GGCX genotypes is determined. It can improve the effect of anticoagulant therapy.
【作者单位】：江苏省连云港市第一人民医院心血管外科;中国医学科学院阜外心血管病医院外科;
【分类号】：R654.2

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