CYP3A4~* 1G、COMT val158met、OPRM1A118G基因多态性对胃癌患者术后舒芬太尼镇痛效应的影响Effect of gene polymorphism of CYP3A4~* 1G,COMT val158met and OPRM1A118G on analgesic effect of sufentanil in patients with gastric cancer after operation
承华薇;曾蓉;李冬冬;
摘要(Abstract):
目的探讨细胞色素P4503A4酶(CYP3A4)CYP3A4~*1G、儿茶酚胺氧位甲基转移酶(COMT)COMT val158met、μ阿片受体编码基因1(OPRM1)OPRM1A118G的单核苷酸多态性(Single Nucleotide Polymorphism,SNP)对胃癌患者术后舒芬太尼镇痛效应的影响。方法选取2019年7月至2019年12月在中国科学技术大学附属第一医院行全胃切除术的70例患者的新鲜血液,术后给予舒芬太尼进行镇痛,采用一代(Sanger)测序方法对抽取的血样进行分析,比较患者术后24 h的VAS评分、舒芬太尼使用剂量及相关不良反应。结果 70例患者中,CYP3A4~*1G、COMT val158met、OPRM1A118G的SNPs均符合Hardy-Weinberg平衡,各基因型患者术后24 h VAS评分比较,差异有统计学意义(P<0.05),术后舒芬太尼使用剂量比较,差异有统计学意义(P<0.05),不良反应比较,差异无统计学意义(P>0.05)。结论 CYP3A4~*1G、COMT val158met、OPRM1A118G 3种基因突变型患者术后舒芬太尼镇痛给药剂量较多,患者对疼痛耐受力更低,患者不良反应发生情况相似。
关键词(KeyWords): 基因多态性;术后镇痛;舒芬太尼
基金项目(Foundation): 中国科学技术大学“科大新医学”联合基金项目(WK9110000015)
作者(Author): 承华薇;曾蓉;李冬冬;
Email:
DOI: 10.14053/j.cnki.ppcr.202101007
参考文献(References):
- [1] Zhang J,Zhang L,Zhao X,et al.Association between MDR/CYP3A4/OPRM1 gene polymorphisms and the post-caesarean fentanyl analgesic effect on Chinese women[J].Gene,2018,3(27):30321-30324.
- [2] Li J,Wei Z,Zhang J,et al.Candidate gene analyses for acute pain and morphine analgesia after pediatric day surgery:African American versus European Caucasian ancestry and dose prediction limits[J].Pharmacogenomics J,2019,19(6):570-581.
- [3] 黄展雄,黄春忠,张超城,等.纳布啡联合舒芬太尼用于剖宫产术后患者静脉自控镇痛的效果[J].中国药物经济学,2019,14(11):98-100.
- [4] Rowland M,Tozer TN,Rowland M,et al.Clinical pharmacokinetics:concepts and applications[M].Pharmacogenetics,2014,15(6):156-183.
- [5] Liu X,Huang X,Zhang S,et al.Correlations between CYP3A4 polymorphism and susceptibility to breast cancer in Chinese Han population[J].Int J Clin Oncol,2019,24(2):179-188.
- [6] Du J,Yu L,Wang L,et al.Differences in CYP3A4*1G genotype distribution and haplotypes of CYP3A4,CYP3A5 andCYP3A7 in 3 Chinese populations[J].Clin Chim Acta,2007,383(1):172-174.
- [7] Wang XS,Song HB,Chen S,et al.Association of single nucleotide polymorphisms of ABCB1,OPRM1 and COMT with pain perception in cancer patients[J].J Huazhong Univ Sci Technolog Med Sci,2015,35(5):752-758.
- [8] Diatchenko L,Slade GD,Nackley AG,et al.Genetic basis for individual variations in pain perception and the development of a chronic pain condition[J].Hum Mol Genet,2005,14(1):135-143.
- [9] Barbosa FR,Matsuda JB,Mazucato M,et al.Influence of catechol-O-methyltransferase (COMT) gene polymorphisms in pain sensibility of Brazilian fibromialgia patients[J].Rheumatol Int,2012,32(2):427-430.
- [10] Xu GH,Gao M,Sheng QY,et al.Opioid receptor A118G polymorphism does not affect the consumption of sufentanil and ropivacaine by patient-controlled epidural analgesia after cesarean section[J].Ther Drug Monit,2015,37(1):53-57.
- [11] Kong X,Deng H,Gong S,et al.Lack of associations of the opioid receptor mu 1 (OPRM1) A118G polymorphism (rs1799971) with alcohol dependence:review and meta-analysis of retrospective controlled studies[J].BMC Med Genet,2017,18(1):120.
- [12] Zhang W,Chang YZ,Kan QC,et al.CYP3A4*1G genetic polymorphisms influences CYP3A activity and response to fentanyl in Chinese gynecologic patients[J].Eur J Clin Pharmaeol,2010,66(1):61-66.
- [13] Yao P,Ding YY,Wang ZB,et al.Effect of gene polymorphism of COMT and OPRM1 on the preoperative pain sensitivity in patients with cancer[J].Int J Clin Exp Med,2015,8(6):10036-10039.
- [14] Matic M,van den Bosch GE,de Wildt SN,et al.Genetic variants associated with thermal pain sensitivity in a paediatric population[J].Pain,2016,157(11):2476-2482.
- [15] Hastie BA,Riley JL 3rd,Kaplan L,et al.Ethnicity interacts with the OPRM1 gene in experimental pain sensitivity[J].Pain,2012,153(8):1610-1619.