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达比加群酯作为非瓣膜心房颤动抗凝治疗新型口服抗凝药,其抗凝作用与华法林相当,出血风险较华法林减少约20%,较华法林具有诸多优势;但达比加群酯抗凝治疗普遍存在个体差异,基因多态性对于达比加群酯的影响可能在于药物代谢及药物动力学方面.CES1和ABCB1等位基因多态性与达比加群酯血药浓度相关,CES1 SNP rs2244613与谷浓度及出血事件相关,携带该等位基因的人群有较低的出血风险,因此CES1 SNP rs2244613是达比加群酯临床出血风险的决定因素.而CES1 SNP G143E对于达比加群酯活化是一种功能缺失型突变,这种突变会影响达比加群酯的激活从而影响达比加群酯的活性及相关不良事件的发生.因此在个体化治疗方案中,可基于基因多态性更好地提高达比加群酯疗效及安全性.“,”Dabigatran etexilate is a new oral anticoagulant for the treatment of nonvalvular atrial fibrillation.The anticoagulant effect is equivalent to warfarin,and the risk of bleeding is about 20%less than warfarin,which has many advantages over warfarin.However,there are individual differences in the anticoagulant therapy of dabigatran etexilate,and the effects of genetic polymorphisms on dabigatran etexilate may be in terms of drug metabolism and pharmacokinetics.The CES1 and ABCB1 allele polymorphism and dabigatran etexilate serum concentration,CES1 and rs2244613 valley concentration and bleeding events associated with the allele groups have a lower risk for bleeding, and CES1 SNP rs2244613 is associated with determinants of risk ester clinical bleeding.The activation of dabigatran etexilate by CES 1 SNP G143E is a functional deletion mutation that affects the activation of dabigatran etexilate,thereby affecting the activity of dabigatran etexilate and associated adverse events.Therefore,the efficacy and safety of dabigatran etexilate can be improved on the basis of genetic polymorphisms in individualized treatment.