The Influence Of VKORC1-1639 And CYP2C9 Polymorphisms,and Nongeretic Factors On Warfarin Stable Dose In Pulmonary Thromboembolism Patients

Objective:To investigate the effects of VKORC1-1639 and CYP2C9 polymorphisms,and nongeretic factors on warfarin stable dose in pulmonary thromboembolism patients,to provide evidence for individualized use of warfarin in patients with pulmonary embolism.Methods:Included in the First Affiliated Hospital of Xinjiang Medical University diagnosed pulmonary embolism in patients taking warfarin 130 patients,and medication for at least 2 months,the international standardization ratio(INR)maintained at between 2-3,using gene chip detected The genotypes of CYP2C9*2,CYP2C9*3 and VKORCI-1639A>G,recorded the patient’s age,sex,weight,height,ethnicity,mean INR,and warfarin stable dose,to predict the warfarin dose by multiple regression analysis.Result:The stable warfarin does were very different in 130 patients,the lowest was 0.75mg/d,up to 6mg/d.Spearman’s bivariate rank correlation analysis showed that age(r_s=-0.293,P=0.001),body surface area(r_s=0.279,P=0.001),height(r_s=0.285,P=0.001),CYP2C9(r_s=-0.281,P=0.001)and VKORC1(r_s=-0.459,P=0.000)were significantly correlated with warfarin stability.The multiple stepwise regression equation was used to determine the warfarin stable dose equation:D=5.083-1.109×VKORC1-1639AG-1.614×VKORC1-1639AA-0.014×age-0.353×CYP2C9+0.525×bodysurface area.This equation can explain the difference between warfarin total individuals 37.4%of the variation.Conclusion:VKORC1-1639,CYP2C9 gene polymorphism and age,body surface area is the main factor contributing to stable doses of warfarin in patients with pulmonary thromboembolism.