中国药物警戒 ›› 2015, Vol. 12 ›› Issue (9): 567-569.

• 医院药事管理与合理用药 • 上一篇    下一篇

华法林常规剂量方案下抗凝效果和相关因素分析

张亚同1, 付春毅2, 李铮1, 董凡1, 胡欣1   

  1. 1.北京医院药学部，北京100730;
    2.北京医院急诊科，北京100730
  • 收稿日期:2015-03-19 修回日期:2015-12-07 出版日期:2015-09-08 发布日期:2015-12-07
  • 作者简介:张亚同，男，硕士，临床药学。
  • 基金资助:
    卫生行业科研专项基金“药物使用安全与输血安全相关技术与标准”(200902008-03)。

Anticoagulation Effect and Association Analysis in Patients on Routine Warfarin Dosage

ZHANG Ya-tong1, FU Chun-yi2, LI Zheng1, DONG Fan1, HU Xin1   

  1. 1.Pharmacy Department, Beijing Hospital, Beijing 100730, China;
    2.Emergency Department, Beijing Hospital, Beijing 100730, China
  • Received:2015-03-19 Revised:2015-12-07 Online:2015-09-08 Published:2015-12-07

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摘要： 目的 探求华法林常规剂量方案下抗凝效果及相关因素。方法 纳入华法林3mg qd po用药且超过5天未调整用药患者，分析华法林抗凝效果，收集患者临床资料，收集患者血液样本并检测患者VKORCl和CYP2C9基因型，统计分析遗传因素和非遗传因素对华法林抗凝的作用与影响。结果 52人(54.74%)凝血酶原时间国际标准化比值(INR值)低于1.8，22人(23.16%) 3 mg方案下INR值大于2.5，仅有21人INR值落在1.8~2.5之间，达标率22.11%。分析遗传因素和非遗传因素对华法林稳定剂量的作用与影响，仅发现年龄因素与INR值相关。结论 多数患者华法林常规剂量应用INR值未达标。未发现遗传因素在常规剂量患者中的影响，发现年龄与这类患者相关。

关键词: 华法林, 常规剂量, VKORC1, CYP2C9, 基因多态性

Abstract: Objective To Explore the anticoagulant effect and related factors under conventional warfarin dosing regimen. Methods Patients under 3 mg per day without dosage change more than 5 days were included, the coagulation effect of warfarin was analyzed, and the patients' blood samples were collected and tested in VKORCl and CYP2C9 genotypes, and clinical data of them were also collected. Genetic factors and non-genetic factors were statistically analyzed on the effect of warfarin's anticoagulation. Results 52 patients had INR values below 1.8, 22 patients higher than 2.5, only 21 patients had INR values between 1.8 and 2.5 which accounted for 22.11%. Genetic factors and non-genetic factors had no impact on warfarin anticoagulation effect, and only the age was associated with INR values of the patients. Conclusion Most patients under routine warfarin dosage had not reached into the target INR values, and the age was still the important factor on the warfarin anticoagulation effect .

Key words: warfarin, conventional dose, VKORC1, CYP2C9, polymorphism

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