华法林出血并发症相关药物基因组学研究进展

华法林作为一线口服抗凝药广泛应用于血栓栓塞性疾病的预防与治疗中,但如何安全有效地应用华法林并达到最佳抗凝效果,一直是临床上亟待解决的难题。近年对华法林药物基因组学的研究表明,华法林代谢和作用相关基因(CYP2C9、VKORC1、CYP4F2)的变异很大程度上影响华法林的治疗剂量,还可能与华法林的出血并发症密切相关。本文对上述基因变异与华法林的过度抗凝及出血的相关研究作一综述,以期为临床华法林的个体化抗凝治疗提供参考依据。

Warfarin related bleeding complications: progress in pharmacogenetic studies

Warfarin is widely used in the prevention and treatment of thromboembolic diseases. But, there still remain challenges for its safe and effective application and for how to obtain its best anticoagulation in clinical practice. In recent years, warfarin pharmacogenetics studies showed that the genetic variants of the genes (CYP2C9, VKORC1 and CYP4F2) related to the pathway of warfarin metabolism and function could affect the therapeutic dose of warfarin dramatically, as well as the risks for bleeding complications. In this review, we focused on the studies concerning on the correlation of above genetic variants with warfarin related over-anticoagulation and bleeding complications, so as to provide clinical reference for individualized anticoagulation therapy.