The Correlation Of CYP2C9、VKORC1、CYP4F2Polymorphisms With Warfarin Does In Fujian Han Population

Objective:To characterize the clinical features and the using of antithrombotics ofnon-valvular atrial fibrillation stroke patients. Discuss the current situation ofwarfarin’s using in non-valvular atrial fibrillation stroke patients in Fujian and thepossible causes for it.Methods:To retrospective analysis of203non-valvular atrial fibrillation stroke patientsinpatients in department of neurology of First Affiliated Hospital of Fujian medicaluniversity between January2010and September2012.Results:1．There were59patients who use warfarin, the utilization rate of warfarinIs30.05%, without the patients who unsuited warfarin,the rate is50.00%.2.Male gender、patients of hypertension、diabetic mellitus、hyperlipemia andsmoking history have higher utilization rate of warfarin. great than or equal to75-year-old patients have higher utilization rate of warfarin than less then75-year-oldpatients.Conclusions:1.The utilization rate of warfarin in non-valvular atrial fibrillation stroke patientsin Fujian is lower then Europe and America，but more than the. non-valvular atrialfibrillation patients who without stroke.2.Male、patients of hypertension、diabetic mellitus、hyperlipemia and smokinghistory are more likely to accept warfarin.3.Younger are more likely to accept warfarin than older. Objective:To discuss the frequencies of CYP2C9、VKORC1and CYP4F2and therelationship with warfarin does in Hujian han populationMethods:We detected the frequencies of CYP2C9*3,VKORC1(-1639G>A) andCYP4F2*3in1006unrelated Fujian Han volunteers by amplification refractorymutation system PCR, and retrospective follow-up visit85cases of patients thattaking warfarin in a long term, records the basic demographic data, concomitantdisease, concomitant medications and the warfarin dosage when INR reaches a stablevalue, and assesses the influence of CYP2C9*2, VKORC1(-1639G> A) andCYP4F2*3to warfarin dose.Results1. Between the1006cases of healthy control group, there is96.02%of AA type,3.98%of AC type and0%of CC type in CYP2C9*3gene;2.1%of GG type,17.6%of GA type,80.3%of AA type in VKORC1(-1639G> A) gene;42.14%of CC type,46.42%of CT type,11.74%of TT type in CYP4F2*3gene.2. Between the85cases of experimental group, the average amount of warfarinin different genotypes is as follows:3.54±0.75mg/d of CYP2C9*3in AA genotype,1.88±0.53mg/d of CYP2C9*3in AC genotype;2.52±0.68mg/d of VKORC1(-1639G> A) in AA genotype,5.34±1.19mg/d of VKORC1(-1639G> A) in GG+GAgenotype; in CYP4F2*3：2.63±0.75mg/d in CC genotype,2.81±0.87mg/d in CTgenotype，3.10±1.35mg/d in TT genotype.Conclusion:1.In Fujian Han populatio, the function of the polymorphisms ofpharmacokinetics genes CYP2C9that affects the warfarin dose is littlle, and the maingene polymorphisms of pharmacodynamics that affects the warfarin dose is VKORC1 (-1639G> A).2. In CYP2C9*3、VKORC1（-1639G>A）and CYP4F2*3, the AC gene type ofCYP2C9*3have least warfarin, the G allele of VKORC1（-1639G>A）need the mostwarfarin.3. By testing the genetype of patients that use warfarin and estimating theamount of medication, we can evaluate the individualized the dose of warfarin quicklyand efficiently.