ABSTRACT
Objective To investigate the CYP2C18,VKORC1 and CYP2C9 genotype distribution situation and the correlation between their polymorphism with warfarin stable dose.Methods A total of 176 Yungui plateau Han patients with continuously warfarin anticoagulation therapy after valve replacement in this hospital from January 2011 to January 2014 served as the research subjects.The venous blood was collected for detecting genotypes at various loci.The genotype and allele frequency distribution were analyzed,and the correlation between the gene polymorphism with warfarin stable dose was analyzed.Results The genotypes and allele frequencies at various loci conformed to the Hardy-Winberg genetic balance (P＞0.05).The polymorphisms of CYP2C18 (rs7896133),VKORC1 (rs9923231),CYP2C9(rs1057910) and CYP2C9(rs4086116) gene loci were correlated with warfarin stable dose (P＞0.05).Conclusion The gene polymorphism of CYP2C18(rs7896133),VKORC1 (rs9923231),CYP2C9(rs1057910) and CYP2C9(rs4086116) in Yungui plateau H an patients may be the influence factors which contribute to warfarin stable dose personalized difference.
ABSTRACT
Objective To investigate the gamma glutamine carboxylase (GGCX ,rs6738645) genotype distribution in Chinese Han population and the correlation between GGCX (rs6738645) polymorphism and the warfarin stable dose in the patient after valve replacement .Methods The genotypes of 228 cases were detected by the Snapshot technology in order to explore the genotype and allele frequencies .The correlation between the gene polymorphism in 176 cases after valve replacement and the stable dose of warfa-rin was compared .Results In total of 228 research subjects ,the number of TT ,GT and GG genotype were 84(36 .84% ) ,122 (53 .51% ) and 22(9 .65% ) .The frequencies of T and G allele were 63 .60% and 36 .40% respectively ;in 176 patients after the valve replacement ,the maintenance stable dose of warfarin was lower in GG group than in the TT and GT groups ,the differences between the groups showed statistical significance (P0 .05) .Conclusion The GGCX(rs6738645) polymorphism in Chinese Han population may be the influencing factor of warfarin individual dose difference in the patients after valve replacement .
ABSTRACT
Objective To investigate the reasonable anticoagulant therapy for patients over sixty five years old in Yunnan-Guizhou plateau after heart biological valve replacement , and study the standard of reasonable anticoagulant therapy. Methods We collected the recent cases by retrospective way . Low-intensity anticoagulation standard INR (1.5~2.5) was used on 130 patients over sixty five years old. The warfarin dose and anticoagulation INR values in different surgery operation were compared when the patients reached the stable anticoagulation status. The frequency of INR values and warfarin dosage were studied. The differences between the patients with high risk factors and the ordinary patients without the high risk factors in INR values and warfarin dosage were investigated. Results The INR values and warfarin doses showed no significant difference (P > 0.05) in different operation groups when they reached stable anticoagulation status. The INR values was 1.94 ± 0.50 and the daily warfarin dose was (2.45 ± 0.82)mg/d. No significant differences in INR values and warfarin doses were found between the high-risk group and the general group (P>0.05) in steady-state. During follow-up, both the incidence rate of thrombosis and general bleeding were 0.77%. Conclusion The precent study showed that the low-intensity anticoagulation INR values (1.5~2.5) can be the standard of reasonable anticoagulation in Yunnan-Guizhou plateau after heart biological valve replacement with satisfactory anticoagulant effect.