基于VKORC1、CYP2C9基因多态性指导自体动静脉内瘘术后短期抗凝治疗效果OA

Objective To investigate the impact of genetic polymorphisms in vitamin K epoxide reductase complex subunit 1(VKORC1)and cytochrome P450 enzyme 2C9(CYP2C9)on short-term anticoagulation therapy efficacy and bleeding risk in patients undergoing autogenous arteriovenous fistula(AVF)surgery.Methods A total of 154 patients who underwent AVF surgery at Jinhua Central Hospital from March 2022 to November 2024 were selected as study subjects.They were randomly divided into observation group(n=76)and control group(n=78)using a random number table method.All patients received short-term anticoagulation therapy postoperatively.Peripheral blood samples were collected preoperatively to detect polymorphisms at the VKORC1 and CYP2C9*3 gene loci.The observation group received warfarin therapy guided by VKORC1 and CYP2C9*3 genotypes,while control group underwent conventional empirical anticoagulation therapy.The changes in international normalized ratio(INR),incidence of bleeding complications,and warfarin dosage were compared between the two groups during anticoagulation therapy.Results There were no statistically significant difference in VKORC1 genotype diversity between two groups(P>0.05).The observation group achieved INR target levels faster than control group,with both the initial and maintenance doses of warfarin being lower than those in control group(P<0.05).The incidence of minor bleeding events and INR≥4.0 events were lower in observation group compared to control group(P<0.05).Conclusion Individualized anticoagulation therapy based on VKORC1 and CYP2C9 gene polymorphisms can significantly improve the efficacy and safety of anticoagulation therapy,while reducing bleeding risks.