CAJ | 학술논문

目的探讨尿苷二磷酸葡萄糖醛酸转移酶1A9 I399C＞T(UGT1A9 I399C＞T)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152例,年龄20 ～ 50岁,体重50 ～ 70 kg,ASA分级Ⅰ级或Ⅱ级.术前采用基因测序技术进行UGT1 A9 I399单核苷酸多态性位点的检测,根据基因型将患者分为野生纯合子(C/C)组、突变杂合子(C/T)组和突变纯合子(T/T)组.麻醉诱导和维持时均靶控输注异丙酚,Cp 3 μg/ml,输注60 min时采集血样,采用高效液相色谱法测定血浆异丙酚浓度.记录停止输注异丙酚至警觉-镇静(OAAS)评分达4分的时间,此时的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24例,突变杂合组96例和突变纯合组32例.等位基因频率T为53％,C为47％.三组患者血浆异丙酚浓度、OAAS评分降至4分时的时间、BIS值、异丙酚效应室浓度和BIS值升至80时的时间、异丙酚效应室浓度比较差异无统计学意义(P＞0.05).结论 UGT1A9 I399C＞T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 탐토뇨감이린산포도당철산전이매1A9 I399C＞T(UGT1A9 I399C＞T)단핵감산다태성대유선수술환자이병분진정효응적영향.방법 택기전마하행량성유선종괴절제술적녀성환자152례,년령20 ～ 50세,체중50 ～ 70 kg,ASA분급Ⅰ급혹Ⅱ급.술전채용기인측서기술진행UGT1 A9 I399단핵감산다태성위점적검측,근거기인형장환자분위야생순합자(C/C)조、돌변잡합자(C/T)조화돌변순합자(T/T)조.마취유도화유지시균파공수주이병분,Cp 3 μg/ml,수주60 min시채집혈양,채용고효액상색보법측정혈장이병분농도.기록정지수주이병분지경각-진정(OAAS)평분체4분적시간,차시적BIS치화이병분효응실농도；BIS치승지80적시간급차시이병분효응실농도.결과 야생순합조24례,돌변잡합조96례화돌변순합조32례.등위기인빈솔T위53％,C위47％.삼조환자혈장이병분농도、OAAS평분강지4분시적시간、BIS치、이병분효응실농도화BIS치승지80시적시간、이병분효응실농도비교차이무통계학의의(P＞0.05).결론 UGT1A9 I399C＞T단핵감산다태성불시인기이병분진정효응개체차이적유전인소.
Objective To investigate the effects of UDP glucuronosyltransferase (UGT) 1A9 I399 C ＞ T single nucleotide polymorphism on postoperative sedation with propofol in patients undergoing breast surgery.Methods One hundred and fifty-two ASA Ⅰ or Ⅱ female patients,aged 20-50 yr,weighing 50-70 kg,scheduled for elective benign breast tumor excision under general anesthesia,were enrolled in this study.The polymorphic sites of the UGT1A9 I399 C ＞ T allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism.The patients were assigned to one of 3 groups according to their genotypes:wild homozygote (C/C) group,mutation heterozygote (C/T) group and mutation homozygote (T/T) group.During induction and maintenance of anesthesia,propofol was given by target-controlled infusion with the plasma concentration (Cp) of 3μg/ml.Blood samples were taken at 60 min after target-controlled infusion of propofol was started for determination of the Cp of propofol using high-performance liquid chromatography.The time when OAAS was 4 after stopping the infusion of propofol was recorded and the BIS value and effect-site concentration of propofol were also recorded at this time.The time when BIS value was 80 was recorded and the effect-site concentration of propofol was also recorded at this time.Results Genotyping analysis revealed that genotype distribution of UGT1A9 I399 C ＞ T polymorphism was C/C 24 cases,C/T 96 cases and T/T 32 cases.The T allele frequency was 53％.The C allele frequency was 47.4％.There was no significant difference in the Cp of propofol,time when OAAS was 4,BIS value and effectsite concentration of propofol when OAAS was 4,time when BIS value was 80 and effect-site concentration of propofol when BIS value was 80 among the three groups (P ＞ 0.05).Conclusion UGT1 A9 I399C ＞ T single nucleotide polymorphism is not the genetic factor contributing to the individual variation in the patient' s response to postoperative analgesia with propofol in patients undergoing breast surgery.