Relationship between antithrombin Ⅲ genetic polymorphism and individual variation in anticoagu-lant effect of heparin in patients of different nationalities / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the relationship between antithrombin Ⅲ(ATⅢ)genetic pol-ymorphism and individual variation in anticoagulant effect of heparin in the patients of different nationalities. Methods Sixty patients of Uighur nationality and 60 patients of Han nationality, aged 18-64 yr, with body mass index of 21-25 kg∕m2, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, undergo-ing elective cardiac surgery under cardiopulmonary bypass, were divided into Uighur group and Han group, respectively. ATⅢ gene polymorphism was detected by polymerase chain reaction(A∕G was heterozygous, A∕A and G∕G were homozygous). Heparin sodium was intravenously injected at 5 min before the start of cardiopulmonary bypass with an amount of ACT≥480 s. The amount of heparin and protamine, intraoper-ative blood transfusion and postoperative 24 h drainage(pericardium, mediastinum∕thoracic cavity)were recorded. Activated partial thromboplastin time and prothrombin time were measured at 10 min before opera-tion and 24 h after operation. Results Compared with Han group, the amount of heparin, ratio of prota-mine to heparin for heparin neutralization and requirement for intraoperative blood transfusion were signifi-cantly decreased, the postoperative drainage volume was decreased, activated partial thromboplastin time was shortened at 24 h after operation, the frequency of A∕A genotype was increased and the frequency of G∕G genotype was decreased at ATⅢ gene single-nucleotide polymorphism sites rs5877 and rs5878, and the minimum allele(A>G)frequency was increased in Uighur group(P<0.05). Conclusion ATⅢ gene polymorphism may be one of the mechanisms underlying individual variation in anticoagulant effect of hepa-rin between the patients of Uighur nationality and Han nationality.