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目的检测维生素 K 环氧化物还原酶复合体1(VKORC1)基因多态性对华法林维持剂量的影响。方法研究入选102例使用华法林的汉族人,用限制性酶切的方法检测其 C1173T 位点多态性,其他临床资料通过随访获得。用独立样本 t 检验比较不同基因型患者华法林维持剂量的差别,用多重线性回归进行回顾性研究,分析华法林抗凝疗效的影响因素。结果 102例患者的 C1173T 位点基因型分别为 TT 基因型83个(81.4%)、CT 基因型16个(15.7%)、CC 基因型3个(2.9%)。在相同的抗凝目标下国际标准化比值1.5～2.5,TT 基因型患者所需华法林剂量明显低于 CT/CC 基因型,分别为(2.54±0.83)mg/d、(4.19±1.16)mg/d(P<0.01)。结论 C1173T 位点多态性对华法林维持剂量有明显的影响,它能解释大约40%的个体间剂量差异(r~2=0.401)。
Objective To investigate the effects of vitamin K epoxide reductase complex 1 (VKORC1) gene polymorphism on warfarin maintenance dose. Methods A total of 102 Han Chinese patients were enrolled in the study. The C1173T polymorphism was detected by restriction enzyme digestion. Other clinical data were obtained by follow-up. Independent samples t test was used to compare warfarin maintenance dose among different genotypes. Multiple linear regression was used to analyze the influencing factors of warfarin anticoagulation efficacy. Results The genotypes of C1173T in 102 patients were TT genotype 83 (81.4%), CT genotype 16 (15.7%) and CC genotype 3 (2.9%), respectively. The warfarin dose required by patients with TT genotype was significantly lower than that of CT / CC genotype (2.54 ± 0.83) mg / d and (4.19 ± 1.16) mg respectively, with an international standardization ratio of 1.5-2.5 for the same anticoagulation target /d(P<0.01). Conclusion The C1173T polymorphism has a significant effect on warfarin maintenance dose, which can account for about 40% of the dose difference between individuals (r ~ 2 = 0.401).