機(jī)械瓣膜置換術(shù)后華法林穩(wěn)定治療劑量預(yù)測模型研究

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關(guān)鍵詞：華法林；基因多態(tài)性；穩(wěn)定治療劑量；藥物遺傳學(xué)算法；中國人群中圖分類號：R654文獻(xiàn)標(biāo)志碼：A文章編號：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

華法林通過競爭性抑制維生素K的肝循環(huán)代謝，影響I、VII、IX、X因子的生成而產(chǎn)生抗凝效果。（剩余10863字）