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人口统计学因素和维生素K环氧化物还原酶复合体亚单位1(VKORC1)1639 G>A基因型对华法林治疗的伊朗患者华法林维持剂量估计值的影响

The Effect of Demographic Factors and VKORC1 1639 G>A Genotypes on Estimated Warfarin Maintenance Dose in Iranian Patients Under Warfarin Therapy.

作者信息

Rad Fariba, Hamidpour Mohsen, Dorgalaleh Akbar, Poopak Behzad

机构信息

1Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.

2Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Indian J Hematol Blood Transfus. 2019 Jan;35(1):167-171. doi: 10.1007/s12288-018-0987-0. Epub 2018 Aug 1.

Abstract

Warfarin is an anticoagulant that inhibits vitamin K-dependent clotting factors including factor (F) II, FVII, FIX and FX. Different factors can change the effect of this anticoagulant in clinic. Therefore we assessed impact of VKORC1 -1639 G>A polymorphism and demographic factors on required maintenance dose in Iranian patients under warfarin therapy. The study population included 95 patients with a mean age of 61.3 ± 12.6 years. Target INR range of 2-3 was considered for these patients. The frequency of VKORC1 -1639 G>A polymorphism was assessed by polymerase chain reaction-restriction length polymorphism (PCR-RFLP). Finally the obtain data were analyzed by SPSS software. Our study revealed that 30.5%, 49.5%, and 20% of the patients had VKORC1 (G/G), (G/A), and (A/A) genotypes, respectively. Carriers of VKORC1 G/G genotype required a higher warfarin dose as compared to A/A carriers (4.48 ± 1.32 and 2.7 ± 1.16 mg/day, respectively;  < 0.01). In addition, patients with higher age required lower warfarin therapeutic dose (r = - 0.3,  < 0.01). It seems that -1639 G>A polymorphism and demographic variables had significant effects on warfarin maintenance dose in Iranian patients under warfarin therapy.

摘要

华法林是一种抗凝剂,可抑制维生素K依赖性凝血因子,包括因子(F)II、FVII、FIX和FX。不同因素可改变这种抗凝剂在临床上的效果。因此,我们评估了VKORC1 -1639 G>A多态性和人口统计学因素对接受华法林治疗的伊朗患者所需维持剂量的影响。研究人群包括95名患者,平均年龄为61.3±12.6岁。这些患者的目标国际标准化比值(INR)范围为2至3。通过聚合酶链反应-限制性片段长度多态性(PCR-RFLP)评估VKORC1 -1639 G>A多态性的频率。最后,使用SPSS软件对获得的数据进行分析。我们的研究显示,分别有30.5%、49.5%和20%的患者具有VKORC1(G/G)、(G/A)和(A/A)基因型。与A/A基因型携带者相比,VKORC1 G/G基因型携带者需要更高的华法林剂量(分别为4.48±1.32和2.7±1.16毫克/天;P<0.01)。此外,年龄较大的患者需要较低的华法林治疗剂量(r=-0.3,P<0.01)。-1639 G>A多态性和人口统计学变量似乎对接受华法林治疗的伊朗患者的华法林维持剂量有显著影响。

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Effect of age and sex on warfarin dosing.年龄和性别对华法林剂量的影响。
Clin Pharmacol. 2014 Jul 12;6:103-6. doi: 10.2147/CPAA.S66776. eCollection 2014.

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