摘要
目的:验证评价4个基于CYP2C9*3和VKORC1-1639G>A基因多态性的华法林稳定剂量预测模型的准确性。方法:收集太和县人民医院2020年1月至2022年7月进行CYP2C9*3和VKORC1-1639G>A基因检测的非瓣膜性房颤患者,将CYP2C9*3和VKORC1基因型和患者基本信息代入华法林稳定剂量预测模型中得到预测剂量,以绝对误差均值和理想预测百分比作为准确性评价指标,应用SPSS 17.0软件进行统计分析。结果:88例房颤患者的CYP2C9*3、VKORC1-1639G>A基因频率均符合Hardy-Weinberg平衡。模型1、2、3、4华法林预测剂量分别为(2.82±0.78),(2.80±0.85),(2.47±0.30),(1.99±0.82)mg·d^(-1),实际剂量为(2.71±0.74)mg·d^(-1);4个模型的绝对误差均值分别为0.11、0.09、-0.24、-0.72 mg·d^(-1)。4个模型理想预测百分比分别为72.73%、70.45%、61.36%、20.45%,模型1最高,模型4最低。散点图结果显示:模型2和模型1预测剂量与实际剂量的相关性较好。一致性检验结果显示:预测剂量与实际剂量一致性最高的是模型1,最低的为模型4。结论:模型1和模型2可以较好地预测房颤患者华法林给药剂量。
OBJECTIVE To verify and evaluate the accuracy of four warfarin stable dose prediction models based on CYP2C9*3 and VKORC1-1639G>A gene polymorphisms.METHODS Non-valvular atrial fibrillation patients who underwent CYP2C9*3 and VKORC1-1639G>A gene detection in Taihe County People’s Hospital from January 2020 to July 2022 were collected. The CYP2C9*3 and VKORC1 genotypes and the basic information of the patients were substituted into the warfarin stable dose prediction model to obtain the predicted dose. The mean absolute error and the ideal prediction percentage were used as the accuracy evaluation indicators, and SPSS 17.0 software was used for statistical analysis.RESULTS The gene frequencies of CYP2C9*3 and VKORC1-1639G>A in 88 patients with atrial fibrillation were both in line with Hardy-Weinberg equilibrium. The predicted doses of warfarin in model 1, 2, 3 and 4 were(2.82±0.78),(2.80±0.85),(2.47±0.30) and(1.99±0.82)mg·d^(-1), respectively, and the actual dose was(2.71±0.74)mg·d^(-1). The mean absolute errors of the four models were 0.11, 0.09,-0.24, and-0.72 mg·d^(-1), respectively. The ideal prediction percentages of the four models were 72.73%, 70.45%, 61.36%, and 20.45%, respectively, and that of model 1 was the highest, and that of model 4 was the lowest. The scatter plot results showed that model 2 and model 1 had good correlation between the predicted dose and the actual dose. The results of consistency test showed that the consistency of model 1 was the highest;the consistency of model 4 was the lowest.CONCLUSION Model 1 and model 2 can better predict the dose of warfarin in patients with atrial fibrillation.
作者
李宇
冯晓俊
张蕾
史天陆
LI Yu;FENG Xiao-jun;ZHANG Lei;SHI Tian-lu(Taihe County People's Hospital of Anhui Province/Taihe Hospital Affiliated to Wannan Medical College,Anhui Fuyang 236600,China;First Affiliated Hospital of University of Science and Technology of China/Anhui Provincial Hospital,Anhui Hefei 230001,China)
出处
《中国医院药学杂志》
CAS
北大核心
2023年第3期285-289,共5页
Chinese Journal of Hospital Pharmacy
基金
皖南医学院校级科研项目(编号:JXYY202141)。
作者简介
李宇,男,硕士,主管药师,研究方向:临床药学;通信作者:史天陆,男,博士,主任药师,研究方向:医院药学。
