中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
20期
3078-3080
,共3页
OPRM1%CYP3A%基因多态性%芬太尼%镇痛效果
OPRM1%CYP3A%基因多態性%芬太尼%鎮痛效果
OPRM1%CYP3A%기인다태성%분태니%진통효과
OPRM1%CYP3A%Genetic polymorphism%Fentanyl%Analgesic effect
目的：探讨腹式子宫全切术患者μ阿片受体（OPRM1）基因、CYP3A基因多态性对芬太尼术后镇痛效果的影响。方法选取198例妇科择期全身麻醉下腹式子宫全切术患者，通过采用聚合酶链反应-限制性片断长度多态性技术检测术后芬太尼静脉镇痛消耗量与OPRM1和CYP3A基因多态性之间的关系。结果198例患者中，OPRM1分型成功的有186例，其余10例患者未能成功分型被剔除，其中A/A型89例， A/G型76例，G/G型21例，OPRM1 A118G等位基因频率为31．7％。 CYP3A4倡1/倡1、CYP3A4倡1/倡1G、CYP3A4倡1G/倡1G三组患者术后即刻及术后24 h平均VAS评分差异无统计学意义；术后第1个24 h芬太尼消耗量采用以方差分析体质量、年龄和术中芬太尼用量作为协变量等因素，三组患者之间差异有统计学意义（P＜0．05），CYP3A4倡1G/倡1G组低于CYP3A4倡1/倡1G组和CYP3A4倡1/倡1组，CYP3A4倡1/倡1G组和CYP3A4倡1/倡1组之间差异无统计学意义（P＞0．05）。另外，由于OPRM1 A118G与CYP3A4倡1G交互作用的存在，降低携带CYP3 A4倡1和OPRM1 A118 G/G者μ阿片受体表达数量，从而术后需要更多的芬太尼来达到相同的镇痛强度。结论分析妇科患者μ阿片受体基因A118G、CYP3A4倡IG多态性可以为临床应用芬太尼术后镇痛个体化用药提供参考。
目的：探討腹式子宮全切術患者μ阿片受體（OPRM1）基因、CYP3A基因多態性對芬太尼術後鎮痛效果的影響。方法選取198例婦科擇期全身痳醉下腹式子宮全切術患者，通過採用聚閤酶鏈反應-限製性片斷長度多態性技術檢測術後芬太尼靜脈鎮痛消耗量與OPRM1和CYP3A基因多態性之間的關繫。結果198例患者中，OPRM1分型成功的有186例，其餘10例患者未能成功分型被剔除，其中A/A型89例， A/G型76例，G/G型21例，OPRM1 A118G等位基因頻率為31．7％。 CYP3A4倡1/倡1、CYP3A4倡1/倡1G、CYP3A4倡1G/倡1G三組患者術後即刻及術後24 h平均VAS評分差異無統計學意義；術後第1箇24 h芬太尼消耗量採用以方差分析體質量、年齡和術中芬太尼用量作為協變量等因素，三組患者之間差異有統計學意義（P＜0．05），CYP3A4倡1G/倡1G組低于CYP3A4倡1/倡1G組和CYP3A4倡1/倡1組，CYP3A4倡1/倡1G組和CYP3A4倡1/倡1組之間差異無統計學意義（P＞0．05）。另外，由于OPRM1 A118G與CYP3A4倡1G交互作用的存在，降低攜帶CYP3 A4倡1和OPRM1 A118 G/G者μ阿片受體錶達數量，從而術後需要更多的芬太尼來達到相同的鎮痛彊度。結論分析婦科患者μ阿片受體基因A118G、CYP3A4倡IG多態性可以為臨床應用芬太尼術後鎮痛箇體化用藥提供參攷。
목적：탐토복식자궁전절술환자μ아편수체（OPRM1）기인、CYP3A기인다태성대분태니술후진통효과적영향。방법선취198례부과택기전신마취하복식자궁전절술환자，통과채용취합매련반응-한제성편단장도다태성기술검측술후분태니정맥진통소모량여OPRM1화CYP3A기인다태성지간적관계。결과198례환자중，OPRM1분형성공적유186례，기여10례환자미능성공분형피척제，기중A/A형89례， A/G형76례，G/G형21례，OPRM1 A118G등위기인빈솔위31．7％。 CYP3A4창1/창1、CYP3A4창1/창1G、CYP3A4창1G/창1G삼조환자술후즉각급술후24 h평균VAS평분차이무통계학의의；술후제1개24 h분태니소모량채용이방차분석체질량、년령화술중분태니용량작위협변량등인소，삼조환자지간차이유통계학의의（P＜0．05），CYP3A4창1G/창1G조저우CYP3A4창1/창1G조화CYP3A4창1/창1조，CYP3A4창1/창1G조화CYP3A4창1/창1조지간차이무통계학의의（P＞0．05）。령외，유우OPRM1 A118G여CYP3A4창1G교호작용적존재，강저휴대CYP3 A4창1화OPRM1 A118 G/G자μ아편수체표체수량，종이술후수요경다적분태니래체도상동적진통강도。결론분석부과환자μ아편수체기인A118G、CYP3A4창IG다태성가이위림상응용분태니술후진통개체화용약제공삼고。
Objective To discuss the influence of μ-opioid receptor ( OPRM1) and CYP3A gene polymor-phism on analgesic effect of fentanyl for abdominal hysterectomy patients .Methods 198 cases of gynecologic anes-thesia patients who were treated by elective abdominal hysterectomy surgery ,were selected in the hospital .The rela-tionship between the fentanyl consumption of intravenous analgesia and OPRMI and CYP 3A gene polymorphisms was detected by using polymerase chain reaction-restriction fragment length polymorphism detection .Results In 198 pa-tients,OPRM1 genotyping was 186 cases,the other 10 patients failed to typing were excluded ,including 89 cases of type A/A,type A/G 76 cases,type G/G 21 cases,OPRM1 the frequency of A118G allele was 31.7%.No statistically significant differences were found in mean VAS score of CYP 3A4*1/*1,CYP3A4*1/*1G,CYP3A4*1G/*1G instantly after operation in the three groups and 24h postoperation.By using analysis of variance with body mass ,age and intraoperative volume as a covariate factors after first 24h fentanyl consumption ,the difference was statistically sig-nificant among the three groups (P<0.05),CYP3A4*1G/*1G group was significantly lower than that in CYP3A4*1/*1G group and CYP3A4*1/*1 group,there was no significant difference between CYP 3A4*1/*1G group and CYP3A4*1/*1 group (P>0.05).In addition,because the OPRM1 A118G interacts with CYP3A4*1G, reducedthe quantity of expression of opioid receptor carrying CYP 3A4*1 and OPRM1 A118G/G,and thus more fent-anyl was needed postoperation to achieve the same effect .Conclusion It provided a theoretical basis and reference for clinical application of personalized medicine by analyzing the gynecological patients μopioid receptor gene A118G and CYP3A4*1G polymorphism.
