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中文摘要：
分析胺碘酮在不同的CYP2C9和VKORC1分型患者对华法林的抗凝作用的影响。纳入从2008年9月至2009年11月某三甲医院应用华法林的入院患者,收集患者一般信息、合并用药及其他临床相关数据,检测患者VKORCl和CYP2C9基因型;比较使用或未使用胺碘酮治疗患者抗凝稳定期INR值及华法林用量,纳入基因分型进行华法林/胺碘酮相互作用的亚组分析。结果未发现胺碘酮应用患者华法林稳定期用量和INR值的统计学差异,基因型亚组差异无统计学意义。这说明院内短期合并使用胺碘酮患者对华法林稳定剂量和INR值无显著影响。
英文摘要：
Warfarin has been used as anticoagulant for the long-term treatment of thromboembolic disease, however, the wide spread use is limited by a wide inter-individual variation in dose requirement. Recent studies have demonstrated that amiodarone may interact with warfarin to potentiate the anticoagulant effects and lead to an elevated international normalized ratio（INR）. In addition, genetic variation in the vitamin K epoxide reductase complex subunit 1（VKORC1） and cytochrome P450 2C9（CYP2C9） may also affect the dose of warfarin in single or combination therapy. In our study, we aim to examine the effect of amiodarone on the warfarin in different CYP2C9 and VKORC1 status. From September 2008 to November 2009, 207 patients from Beijing, China were enrolled in our study, including 34 patients on combination therapy of amiodarone and warfarin and 173 patients on warfarin therapy. VKORCl and CYP2C9 genotypes were examined using ligation detection reaction（LDR） method. We compared the stable dosage of warfarin and INR between patients on warfarin therapy and patients on warfarin-amiodarone therapy when they are stratified with VKORC1 or CYP2C9 genotype. We did not observe significant difference in dosage or INR between these two groups. The difference in characteristics between these two groups, the blood collection time after amiodarone administration and the method for monitoring may all contribute to the negative finding. Large studies taking into account of these factors are needed to improve our understanding of the interaction between warfarin and amiodarone, as well as the effect of genotype in such interaction.
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