华法林抗凝个体化治疗研究进展

摘要/Abstract

摘要： 华法林是临床使用最多的口服抗凝药,其治疗窗窄,剂量个体差异大,容易发生出血或栓塞的风险,如何准确地调整华法林剂量一直是其抗凝治疗的关键及研究热点。多种因素均会影响华法林剂量,尤其是遗传因素(主要是CYP2C9、VKORC1及CYP4F2基因)。近十年来,基于药物基因组学的剂量预测模型和药代动力学药效学的快速发展,为华法林个体化治疗提供了新的契机。该文结合国内外各种华法林稳定剂量预测模型研究,总结影响华法林剂量相关因素的最新研究进展,旨在为华法林个体化治疗提供参考和指导依据。

关键词: 华法林, 个体化治疗, 药物基因组学, 剂量预测模型, 群体药代动力学药效学

Abstract: Warfarin is the most usually used oral anticoagulant with narrow therapeutic window,wide inter-individual variability and high risks of bleeding or thromboembolism.How to accurately adjust the dosage of warfarin has been the key point and hot topic of the anticoagulant therapy.Many factors may influence the dosage of warfarin, especially genomic aspects(mainly CYP2C9,VKORC1 and CYP4F2). Over the last decade, there exist a new opportunity for warfarin individual treatment with the fast development of warfarin pharmacogenetic algorithms and Population Phamacoketic/Pharmacodynamic models.Based on numerous warfarin stable dosage prediction algorithms studies,this review updates the studies of warfarin personalized treatment,with the aim of providing evidence for clinical practice.

Key words: warfarin, personalized treatment, pharmacogenetic, dose algorithm, population pharmacokinetics pharmacodynamics

中图分类号:

R968

胡静, 朱君荣, 于锋. 华法林抗凝个体化治疗研究进展[J]. 中国临床药理学与治疗学, 2014, 19(5): 591-596.

HU Jing, ZHU Junrong, YU Feng. Dosing algorithms for warfarin individualized therapy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(5): 591-596.

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