| Objective: To analyze the role of the pharmacogenomics of warfarin in clinical anticoagulation therapy.Methods: According to the criteria, 62 patients of the Department of Cardiovascular Surgery underwent cardiac valve surgery for the first time in the Second Affiliated Hospital of Kunming Medical University from July 2015 to December 2016 were selected, and they were divided into experimental group (warfarin genome detection) and control group(not warfarin genome detection), all patients were given oral warfarin sodium for anticoagulation therapy within 24 hours after postoperative removal of endotracheal intubation, and adjusted the warfarin to the appropriate dose based on the monitoring results of the International StandardizationRatio (INR) in coagulation tests. Compared the differences of warfarin steady dose and the success rate of anticoagulation treatment between the experimental group and the control group, and the differences between the predicted dose and the steady dose in the experimental group.Results: In the experimental group, the CYP2C9*2 gene was mainly CC (100%),the CYP2C9*3 gene was mainly AA (97.22%), (AC2. 78%); VKORC1 gene was mainly AA(88. 9%), GG(0%), GA(1.11%); There was no significant difference between the experimental group and the control group in the warfarin steady dose and the incidence of adverse reactions during hospitalization(P<0.05) ; In the experimental group, there was a significant difference in the success rate of anticoagulation indexes after 3 days, 5 days, 7 days of medication and before discharge (P<0.01) ; In the experimental group, the warfarin predicted dose was significantly higher than steady dose, and there had a correlation between predicted dose and steady dose(r=0.952, P<0.001) .Conclusion(s): The pharmacogenomics of warfarin has certain reference value in clinical anticoagulation therapy, however, there were also obvious limitations, which needed to be further large-scale clinical studies. |
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