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目前,华法林是临床上广泛用来防治心房颤动患者血栓栓塞并发症的、最有效的口服抗凝药物,但其治疗窗窄,个体差异大,影响因素复杂,易导致疗效不足或出血,甚至致死性出血的并发症。如何合理、安全、有效地使用华法林成为目前国内外研究者的重点和难点;且疗效受多种因素的影响,以遗传因素中基因多态性较为突出。现从基因角度综述细胞色素P4502C9和维生素K环氧化物还原酶基因多态性对心房颤动患者华法林药反应差异的影响。
At present, warfarin is the most effective oral anticoagulant drug widely used to prevent and treat thromboembolic complications in patients with atrial fibrillation. However, its therapeutic window is narrow, the individual differences are large, the influencing factors are complicated, and the curative effect is easily caused by insufficient efficacy or bleeding. Even fatal bleeding complications. How to use warfarin rationally, safely and effectively has become the focus and difficulty of researchers at home and abroad. The efficacy is affected by many factors, and the genetic polymorphism is more prominent. Genes from the perspective of cytochrome P4502C9 and vitamin K epoxide reductase gene polymorphisms in response to warfarin in patients with atrial fibrillation differences in response.