CAJ | 학술논문

目的观察尿苷二磷酸葡萄糖醛酸转移酶(UGTs) 1A9-1818T＞C (UGT1A9-1818T＞C)单核苷酸多态性对乳腺手术患者异丙酚镇静效应的影响.方法择期全麻下行良性乳腺肿块切除术的女性患者150例,年龄20 ～50岁,体质量50 ～70 kg,ASA Ⅰ或Ⅱ级.术前采用基因测序技术进行UGT1A9-1818T＞C单核苷酸多态性位点的检测,根据基因型将患者分成野生纯合子(T/T)组、突变杂合子(T/C)组和突变纯合子(C/C)组.麻醉诱导和维持时均采用靶控输注(TCI)异丙酚,血浆靶浓度为3 mg/L.记录患者停止输注异丙酚至警觉-镇静(OAA/S)评分达4分的时间,此时的脑电双频谱指数(BIS)值和异丙酚效应室浓度；BIS值升至80的时间及此时异丙酚效应室浓度.结果野生纯合组50例、突变杂合组77例和突变纯合组23例,等位基因频率T为59％,C为41％.异丙酚镇静效应存在较大的个体差异；3组患者OAA/S评分达4分的时间、BIS值、异丙酚效应室浓度和BIS值升至80的时间、异丙酚效应室浓度比较差异无统计学意义(P＞0.05).结论 UGT1A9-1818T＞C单核苷酸多态性不是引起异丙酚镇静效应个体差异的遗传因素.
목적 관찰뇨감이린산포도당철산전이매(UGTs) 1A9-1818T＞C (UGT1A9-1818T＞C)단핵감산다태성대유선수술환자이병분진정효응적영향.방법 택기전마하행량성유선종괴절제술적녀성환자150례,년령20 ～50세,체질량50 ～70 kg,ASA Ⅰ혹Ⅱ급.술전채용기인측서기술진행UGT1A9-1818T＞C단핵감산다태성위점적검측,근거기인형장환자분성야생순합자(T/T)조、돌변잡합자(T/C)조화돌변순합자(C/C)조.마취유도화유지시균채용파공수주(TCI)이병분,혈장파농도위3 mg/L.기록환자정지수주이병분지경각-진정(OAA/S)평분체4분적시간,차시적뇌전쌍빈보지수(BIS)치화이병분효응실농도；BIS치승지80적시간급차시이병분효응실농도.결과 야생순합조50례、돌변잡합조77례화돌변순합조23례,등위기인빈솔T위59％,C위41％.이병분진정효응존재교대적개체차이；3조환자OAA/S평분체4분적시간、BIS치、이병분효응실농도화BIS치승지80적시간、이병분효응실농도비교차이무통계학의의(P＞0.05).결론 UGT1A9-1818T＞C단핵감산다태성불시인기이병분진정효응개체차이적유전인소.
Objective To investigate the effects of UGT1 A9-1818T ＞ C single nucleotide polymorphism on sedation with propofol.Methods 150 ASA Ⅰ or Ⅱ female patients,aged 20-50 years,scheduled for elective excision of benign breast lumps under general anesthesia,were enrolled in this study.The polymorphic sites of the UGT1A9-1818T ＞ C allele were analyzed by using polymerase chain reaction and gene sequencing technology.The patients were assigned to one of 3 groups according to their genotypes:wild homozygote group,mutation heterozygote group and mutation homozygote group.Anesthesia was induced by propofol target controlled infusion (TCI) with serum concentration of 3 mg/L,until the patients lost consciousness,intravenous remifentanil and cis-atracurium.The LMA and mechanical ventilation were recorded.Anesthesia was maintained by propofol TCI (3 mg/L),remifentanil continuous infusion,intermittent injection of cis-atracurium.The time,effect-site concentration and bispectral index (BIS) values were recorded when the OAA/S of patients was 4 after stopping the infusion of propofol,and the time and effect-site concentration were recorded when BIS value was 80.Sedation effects of propofol among all groups were compared by using ANOVA.Results There was large individual differences in the propofol sedative effects,but no significant difference was found among the three groups.Conclusion UGT1 A9 -1818T ＞ C SNP site is not the genetic factor that contributing to the individual variation in propofol sedation effects.