中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2009年
1期
12-16
,共5页
张瑞%杜波%谭云龙%张瑞国%马现仓%李玲芝%卢天兰%沙莎%岳伟华%张鸿燕
張瑞%杜波%譚雲龍%張瑞國%馬現倉%李玲芝%盧天蘭%沙莎%嶽偉華%張鴻燕
장서%두파%담운룡%장서국%마현창%리령지%로천란%사사%악위화%장홍연
抑郁症%帕罗西汀%P糖蛋白%多态性,单核苷酸
抑鬱癥%帕囉西汀%P糖蛋白%多態性,單覈苷痠
억욱증%파라서정%P당단백%다태성,단핵감산
Depressive disorder%Paroxetine%P-Glycoprotein%Polymorphism,single nucleotide
目的 探索中国汉族重性抑郁障碍(MDD)患者多药耐药基因(MDR1)多态性与帕罗西汀疗效及药物不良反应的关联.方法 对116例MDD患者给予帕罗西汀治疗,剂量范围20～50mg/d,疗程8周.采用限制性片段长度多态性技术及DNA测序方法检测MDR1基因上5个单核苷酸多态性的基因型,分析各位点基因型及多位点组成的单体型与帕罗西汀临床效应的关系.结果 携带rs1128503位点CC基因型患者的临床缓解率低于其他基因型携带者(TT基因型86.0%,CT基因型72.4%,CC基因型50.0%,P<0.05),且焦虑/躯体化因子减分率较低(P<0.05).携带单体型C-A(rs1128503-rs1202169)患者的临床痊愈率(69.7%)低于非携带者(86.0%),P<0.05.而携带单体型T-A/T-T-G(rs1045642-rs2032582-rs1128503-rs1202169)的患者药物不良反应发生率(29.0%)低于非携带者(49.0%),P<0.05.结论 MDR1基因多态性可能与中国汉族MDD患者帕罗西汀的疗效及不良反应关联.
目的 探索中國漢族重性抑鬱障礙(MDD)患者多藥耐藥基因(MDR1)多態性與帕囉西汀療效及藥物不良反應的關聯.方法 對116例MDD患者給予帕囉西汀治療,劑量範圍20～50mg/d,療程8週.採用限製性片段長度多態性技術及DNA測序方法檢測MDR1基因上5箇單覈苷痠多態性的基因型,分析各位點基因型及多位點組成的單體型與帕囉西汀臨床效應的關繫.結果 攜帶rs1128503位點CC基因型患者的臨床緩解率低于其他基因型攜帶者(TT基因型86.0%,CT基因型72.4%,CC基因型50.0%,P<0.05),且焦慮/軀體化因子減分率較低(P<0.05).攜帶單體型C-A(rs1128503-rs1202169)患者的臨床痊愈率(69.7%)低于非攜帶者(86.0%),P<0.05.而攜帶單體型T-A/T-T-G(rs1045642-rs2032582-rs1128503-rs1202169)的患者藥物不良反應髮生率(29.0%)低于非攜帶者(49.0%),P<0.05.結論 MDR1基因多態性可能與中國漢族MDD患者帕囉西汀的療效及不良反應關聯.
목적 탐색중국한족중성억욱장애(MDD)환자다약내약기인(MDR1)다태성여파라서정료효급약물불량반응적관련.방법 대116례MDD환자급여파라서정치료,제량범위20～50mg/d,료정8주.채용한제성편단장도다태성기술급DNA측서방법검측MDR1기인상5개단핵감산다태성적기인형,분석각위점기인형급다위점조성적단체형여파라서정림상효응적관계.결과 휴대rs1128503위점CC기인형환자적림상완해솔저우기타기인형휴대자(TT기인형86.0%,CT기인형72.4%,CC기인형50.0%,P<0.05),차초필/구체화인자감분솔교저(P<0.05).휴대단체형C-A(rs1128503-rs1202169)환자적림상전유솔(69.7%)저우비휴대자(86.0%),P<0.05.이휴대단체형T-A/T-T-G(rs1045642-rs2032582-rs1128503-rs1202169)적환자약물불량반응발생솔(29.0%)저우비휴대자(49.0%),P<0.05.결론 MDR1기인다태성가능여중국한족MDD환자파라서정적료효급불량반응관련.
Objective To explore the multidrug resistance 1 (MDR1) polymorphisms with the therapeutic efficacy and adverse drug reaction (ADR) of paroxetine in Chinese Han major depressive disorder (MDD) patients. Methods Polymerase chain reaction-restriction fragment length polymorphism or DNA sequencing were used to genotype 5 single nucleotide polymorphisms of MDR1 gene in 116 MDD patients treated with 20-50 mg/d paroxetine for 8 weeks. Association of the 5 SNPs and haplotypes with the clinical response to paroxetine was analyzed. Results The MDD patients with genotype CC of rs1128503 were associated with lower rates of remission (TT 86.0%, CT 72.4%, CC 50.0%, P<0.05) and with lower reducing score rates of anxiety/somatization factor (P<0.05). Patients with the haplotype C-A (rs1128503-rs1202169) showed lower remission rates (C-A 69.7% vs. Non-C-A 86.0%, P<0.05), and patients with the haplotype T-A/T-T- G (rs1045642-rs2032582-rs1128503-rs1202169) exhibited lower rates of ADR (T-A/T-T-G 29.0% vs. Non-T-A/T-T-G 49.0%, P<0.05). Conclusion Among Han Chinese, the polymorphisms of the MDR1 gene may be associated with the efficacy and adverse drug reaction of paroxetine in MDD patients.
