基因检测在临床使用华法林的应用方法讲义.pptVIP

* 2013华法林抗凝治疗的 中国专家共识 * * 积分≥3分时提示“高危”，出血高危患者无论接受华法林还是阿司匹林治疗，均应谨慎，并在开始抗栓治疗之后定期复查 aHypertension’ is defined as systolic blood pressure .160 mmHg. ‘Abnormal kidney function’ is defined as the presence of chronic dialysis or renal transplantation or serum creatinine ≥200 mmol/L. ‘Abnormal liver function’ is defined as chronic hepatic disease (e.g. cirrhosis) or biochemical evidence of significant hepatic derangement (e.g. bilirubin胆红素 .2 x upper limit of normal, in association with转氨酶 aspartate aminotransferase/alanine aminotransferase/alkaline phosphatase .3 x upper limit normal, etc.). ‘Bleeding’ refers to previous bleeding history and/or predisposition to bleeding, e.g. bleeding diathesis, anaemia, etc. ‘Labile INRs’ refers to unstable/high INRs or poor time in therapeutic range (e.g. ,60%). Drugs/alcohol use refers to concomitant use of drugs, such as antiplatelet agents, non-steroidal anti-inflammatory drugs, or alcohol abuse, etc. * * The human genome is the complete set of instructions for life as we know it. Except for red blood cells, which have no nuclei, the human genome is located in the nucleus of every cell in the body. There it is organized into 46 chromosomes; 44 are called autosomes and 2 are called the sex chromosomes. * Chromosomes are made of deoxyribonucleic acid (DNA). DNA contains only four chemical bases or building blocks: adenine, thymine, cytosine, and guanine--called A, T, G, and C, for short. There are roughly 3.2 billion chemical bases (A, T, C, G) in the human genome. Each DNA molecule is made up of two long complementary (related) strands, which are intertwined like a rope. This is the famous “double helix.” Since A always pairs with T, and C with G, the order on one strand dictates the order on the other. This is called base pairing and enables the genome to make copies of itself. * Only about 3 percent of the human genome is actually used as the set of instructions. These regions are called coding regions, and they are scattered