發(fā)布時間：2018-03-03 05:26

  本文選題：CYPC基因型　切入點：GGCX基因型　出處：《中國現(xiàn)代醫(yī)學雜志》2017年18期 　論文類型：期刊論文

【摘要】：目的了解不同CYP2C9及GGCX基因型對人工瓣膜置換術后抗凝效果的影響。方法選取2013年1月-2016年12月在該院心臟外科接受心臟瓣膜置換術的患者,采集服藥后空腹12 h的外周靜脈血3 ml進行CYP2C9和GGCX基因型檢測,收集患者相關臨床資料,采用SPSS 21.0軟件進行數(shù)據(jù)分析。結(jié)果選取80例患者,CYP2C9基因型有2種,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。兩種基因型患者在性別、年齡、體質(zhì)指數(shù)(BMI)、凝血酶原時間(PT)、國家標準化比值(INR)值及達到穩(wěn)定抗凝效果后的華法林血藥濃度差異無統(tǒng)計學意義(P0.05),但CYP2C9*1*1型患者INR首次達標時間CYP2C9*1*3型患者(P=0.013),CYP2C9*1*1型患者華法林日均穩(wěn)定維持劑量CYP2C9*1*3型患者(P=0.011),GGCX*A*G型患者華法林日均穩(wěn)定維持劑量GGCX*G*G型患者(P=0.000),同時為CYP2C9*1*1型和GGCX*A*G型的患者華法林日均穩(wěn)定維持劑量其他3組(P=0.024)。CYP2C9基因型(P=0.001)和GGCX基因型是影響患者術后第6天是否能達到治療窗的影響因素(P=0.032)。結(jié)論根據(jù)CYP2C9基因型和GGCX基因型確定個人使用劑量,可提高患者抗凝治療效果。
[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.
【作者單位】： 江蘇省連云港市第一人民醫(yī)院心血管外科;中國醫(yī)學科學院阜外心血管病醫(yī)院外科;
【分類號】：R654.2

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本文編號：1559735