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CYP3A4 、CYP3A5 基因多态性对患者腹腔镜术后舒芬太尼自控静脉镇痛的影响Effects of genetic polymorphism of
CYP3A4 andCYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery- 陆军军医大学学报 2022年44卷第9期 页码：930-934
- 作者机构：
1.400038 重庆，陆军军医大学(第三军医大学)：第一附属医院麻醉科
2.400038 重庆，陆军军医大学(第三军医大学)：药学与检验医学系生药学与中药学教研室
- 作者简介：
[顾健腾，E-mail: gjt1976@163.comGU Jianteng, E-mail: gjt1976@163.com
- 基金信息：陆军军医大学人才基金(XZ2019-505-028)
DOI：10.16016/j.2097-0927.202110037
中图分类号： R394.5;R614.24;R971.2收稿：2021-10-10，
修回：2021-12-08，
纸质出版：2022-05-15
- 稿件说明：
移动端阅览
古丽, 周莉, 李勇帅, 等.
CYP3A4 、CYP3A5 基因多态性对患者腹腔镜术后舒芬太尼自控静脉镇痛的影响[J]. 陆军军医大学学报, 2022,44(9):930-934.Li GU, Li ZHOU, Yongshuai LI, et al. Effects of genetic polymorphism of
CYP3A4 andCYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery[J]. Journal of Army Medical University, 2022, 44(9): 930-934.古丽, 周莉, 李勇帅, 等.
CYP3A4 、CYP3A5 基因多态性对患者腹腔镜术后舒芬太尼自控静脉镇痛的影响[J]. 陆军军医大学学报, 2022,44(9):930-934. DOI： 10.16016/j.2097-0927.202110037.Li GU, Li ZHOU, Yongshuai LI, et al. Effects of genetic polymorphism of
CYP3A4 andCYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery[J]. Journal of Army Medical University, 2022, 44(9): 930-934. DOI： 10.16016/j.2097-0927.202110037.
摘要
目的
2
探索不同
CYP3A4
和
CYP3A5
基因型患者腹腔镜术后舒芬太尼自控静脉镇痛(patient- control intravenous analgesia
PCIA)的差异。
方法
2
据
CYP3A4
、
CYP3A5
基因型将人群分为Ⅰ类(
CYP3A4
纯合突变，或
CYP3A4
杂合突变合并
CYP3A5
纯合突变)、Ⅱ类(
CYP3A4
杂合突变合并
CYP3A5
杂合突变)、Ⅲ类(
CYP3A4
野生型，或
CYP3A4
杂合突变合并
CYP3A5
野生型)。纳入2020年11月至2021年9月我院普外科和泌尿外科腹腔镜手术患者行观察性研究，于麻醉术前评估时采集患者口腔拭子行
CYP3A4
和
CYP3A5
基因检测，据其基因型并按男女1 ∶1比例，采用随机信封法和盲法分为A、B、C 3组，每组纳入30例患者，每组基因型待数据收集完毕并统计分析后，进行两次揭盲公布。3组患者术后均接受舒芬太尼PCIA。收集患者术后12、24和48 h的视觉模拟镇痛评分、Ramsay镇静评分、舒芬太尼累积用量、镇痛泵按压次数、恶心呕吐发生率等情况并进行分析。
结果
2
共采集口腔拭子标本256份，纳入A、B、C组的病例分别有23、24和27例完成本研究。数据采集完毕并统计分析后，公开A、B、C 3组患者基因型类型分别对应Ⅰ、Ⅱ、Ⅲ类人群。与A组比较，术后12 h时C组患者Ramsay评分显著升高(
P
＜0.05)，术后24、48 h时Ramsay评分3组间差异均无统计学意义。3类人群术后12、24、48 h的VAS评分、舒芬太尼用量、镇痛泵按压次数、恶心呕吐发生率差异均无统计学意义。
结论
2
CYP3A4
、
CYP3A5
基因多态性对腹腔镜手术后用舒芬太尼行术后PCIA无明显影响。
Abstract
Objective
2
To explore the differences of postoperative patient-controlled intravenous analgesia (PCIA) with sufentanil in the patients with different
CYP3A4
and
CYP3A5
genotypes after laparoscopic surgery.
Methods
2
According to
CYP3A4
and
CYP3A5
genotypes
the population are divided into class Ⅰ (
CYP3A4
homozygous mutation
or
CYP3A4
heterozygous mutation combined with
CYP3A5
homozygous mutation)
class Ⅱ (
CYP3A4
heterozygous mutation combined with
CYP3A5
heterozygous mutation)
and class Ⅲ (
CYP3A4
wild type
or
CYP3A4
heterozygous mutation combined with
CYP3A5
wild type). The patients undergoing laparoscopic surgeries in the departments of general surgery and urology of our first affiliated hospital from November 2020 to September 2021 were included in this prospective observational study. Oral swabs were collected for gene detection on
CYP3A4
and
CYP3A5
during the pre-anesthesia evaluation. According to their genotypes and 1 ∶1 ratio of men and women
they were randomly divided into group A
B and C by the randomized envelope and blind methods
with 30 patients in each group. The gene types of each group would be revealed through 2 steps. All patients in 3 groups received postoperative intravenous analgesia with sufentanil. The data
at 12
24 and 48 h after surgery were collected as the following: visual analog analgesia score (VAS)
Ramsay sedation score
cumulative dose of sufentanil
numbers of analgesic pump compressions
and incidence of postoperative nausea and vomiting.
Results
2
A total of 256 oral swab specimens were collected
and 23
24
and 27 patients in group A
B an
d C completed the study respectively. After data collection and statistical analysis
the genotype types of the patients in groups A
B and C were disclosed
corresponding to class Ⅰ
Ⅱ and Ⅲ populations respectively. Compared with class Ⅰ
the Ramsay score was significantly increased at 12 h after surgery in the patients from class Ⅲ (
P
<
0.05)
and there was no statistically significant difference in Ramsay score among the 3 populations at 24 and 48 h after surgery. There were no statistical differences in the VAS scores
cumulative dosage of sufentanil
number of analgesic pump compressions
and incidence of postoperative nausea and vomiting among the 3 groups 12
24 and 48 h after surgery.
Conclusion
2
Genetic polymorphisms of
CYP3A4
and
CYP3A5
have no significant effects on analgesic efficacy of postoperative PCIA with sufentanil after laparoscopic surgery.
关键词
Keywords
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