华法林基因多态性检测指导用药对房颤患者INR、TTR值的影响

doi:10.3969/j.issn.1671-7171.2023.02.016

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Abstract 【Objective】To investigate the effect of warfarin gene polymorphism detection on the initial international normalized ratio (INR) and the percentage of time to target (TTR) in patients with atrial fibrillation.【Methods】 A total of 112 patients with atrial fibrillation treated with warfarin were divided into the observation group (n=59,guided by warfarin gene polymorphism detection) and the control group (n=53,administered empirically) according to different administration methods. The distribution of different genotypes in the observation group was analyzed,and the predicted dose and steady-state dose of warfarin in patients with different genotypes in the observation group were compared. The occurrence of excessive anticoagulation events (INR>3.5 events) and insufficient anticoagulation events (INR<1.2 events) were compared between the observation group and the control group,and the difference in TTR and the incidence of adverse events of INR between the observation group and the control group at different times were compared. 【Results】The distribution of CYP2C9 * 3 genotype and VKORC1 genotype in the observation group conformed to Hardy Weinberg genetic balance law (P>0.05). In CYP2C9 * 3 genotype,there was no significant difference between the predicted dose and the steady-state dose of warfarin of AA,AC and CC genotype (P>0.05); There was no significant difference between the predicted dose and the steady dose of warfarin of AA type,GA type and GG type in VKORC1 genotype (P>0.05). The incidences of events with INR>3.5 and INR<1.2 in the observation group were lower than those in the control group (P<0.05). The TTR value of the observation group in the first 1 month and 3 months before INR was significantly higher than that of the control group (P<0.05),and there was no significant difference between the TTR value of the first 6 months and that of the control group (P>0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). 【Conclusion】 Warfarin gene polymorphism detection can maintain the INR of patients with atrial fibrillation in a more stable range,and TTR can reach a higher level at the beginning of drug use,which can improve the safety of drug use and is worthy of clinical promotion.

Key words： Atrial Fibrillation Warfarin Gene Expression Polymorphism, Genetic International Normalized Ratio

Received: 30 June 2022

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R541.71

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	XING Xin
	MAO Dian-bo

Cite this article:

XING Xin,MAO Dian-bo. Effect of Warfarin Gene Polymorphism Detection on INR and TTR in Patients with Atrial Fibrillation[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(2): 216-219.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.02.016 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I2/216

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