机械瓣膜置换术后华法林稳定治疗剂量预测模型研究

打开文本图片集

关键词：华法林；基因多态性；稳定治疗剂量；药物遗传学算法；中国人群中图分类号：R654文献标志码：A文章编号：1001-5779（2025）05-0441-07DOI：10.3969/j.issn. 1001-5779.2025.05.005

Abstract：Objective：This studyaimed todevelopanoptimized modelfor warfarindosing inpatients post-artificialmechanical valvereplacementbyanalyzing multi-gene polymorphisms alongside clinical variables toenhance modelaccuracy andpredictivecapability.Methods：Clinicaldata from522patients were meticulously trackedandrecorded，with gene polymorphisms identifiedthrough Sangersequencing techniques.The impactof gene polymorphisms and clinical variables on thedailystable doseof warfarin was assessed using multiplelinear regression analysis.During the stepwiseregression process，multicolinear variableswere systematically screened out toconstruct acomputational model predicting stable warfarindoses.Clinical eficacyperformance was evaluatedbasedonthedesired predicted percentage.Results：A totalof 297 patients were included formodelinferenceand validation purposes.Thenewlydeveloped modelis expresedas follows： Y=0.048-0.012（age）+1.512（BSA）-0.812（rs9923231 AA） +1 1.811（rs9923231 GG）+1.581（rs1057910 AA） -1 .090 （rs1057910 AG）-0.159（rs699664 AA）. This model accounts for approximately 60% of the variance observed in individualized drug dosing requirements.Conclusion： GGCX（rs699664） may serve as a potential predictorfordetermining warfarindosage;ournewlyestablished modelholds promiseforguiding personalized warfarin administrationwithinclinical practice among the southern Chinese population.

KeyWords：Warfarin; Gene polymorphism； Stable therapeutic dose；Pharmacogenetic algorithm；Chinese population

华法林通过竞争性抑制维生素K的肝循环代谢，影响I、VII、IX、X因子的生成而产生抗凝效果。（剩余10863字）