CYP2D6*10等位基因多态性对胃癌术后曲马多镇痛效果的影响  

Effect of the CYP2D6*10 allele on postoperative tramadol analgesia in patients after gastric cancer surgery

作　　者：汪国香[1] 黄丽霞[1] 张相彩[2] 陶凡[1] 

机构地区：[1]浙江省中西医结合医院麻醉疼痛科,杭州310003 [2]浙江省中西医结合医院临床药理科,杭州310003

出　　处：《中国中西医结合外科杂志》2011年第5期465-468,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：杭州市医药卫生科技计划项目(2005B061);浙江省公益性技术应用研究计划项目(2010C33120)

摘　　要：目的:探讨中国人群CYP2D6*10等位基因对胃癌术后曲马多镇痛效果的影响。方法:70例胃癌根治术患者,手术结束前30min静脉注入负荷剂量曲马多100mg,随后采用持续背景剂量-PCA量的给药模式(曲马多10mg/mL、甲氧氯普胺0.3mg/mL)进行术后镇痛。全麻诱导后抽取血样,采用聚合酶链反应-限制性片断长度多态性方法分析患者CYP2D6*10基因多态性,根据不同CYP2D6基因型分为3组,比较不同基因组患者之间曲马多的用量。结果:CYP2D6*10等位基因频率为52.4%,不携带CYP2D6*10(I组)17例,CYP2D6*10杂合子(II组)26例,CYP2D6*10纯合子(III组)20例。48h曲马多用量,III组明显高于I组和II组,I组和II组之间差异无统计学意义。结论:在中国人群中,CYP2D6*10等位基因对曲马多镇痛效果有显著影响。Objective To investigate whether the CYP2D6＊10 allele has an impact on the postoperative analgesia effect of tramadol in Chinese patients suffering from gastric cancer surgery.Methods Seventy gastric cancer patients suffering from gastrectomy were enrolled.After receiving a loading dose of 100 mg tramadol intravenously,patients could self-administer doses of 10 mg/mL tramadol plus 0.3 mg/mL metoclopramide via patient-controlled analgesia （PCA）.Blood samples were collected after induction of anesthesia.The CYP2D6＊10 polymorphism was analyzed by means of polymerase chain reaction-based restriction fragment length polymorphism（PCR-RFLP）.Demographic data among groups with different genotypes were analyzed using analysis of variance.The total consumption of tramadol between the three genotype groups for 48 h was compared.Results The allele frequency of CYP2D6＊10 is 52.4%：Patients were categorized into three groups according to the CYP2D6 genotype：patients without CYP2D6＊10 （group I,n=17）,patients with heterozygote for CYP2D6＊10 （group II,n=26）,and patients with homozygote for CYP2D6＊10 （group III,n=20）.The demographic data among the three groups were comparable.The total consumption of tramadol for 48 h in group III was significantly higher than that in other two groups,while it did not differ between groups I and II.Conclusions This study indicates that the CYP2D6＊10 allele has significant impact on analgesia of tramadol in a Chinese population.

关 键 词：细胞色素P4502D6 等位基因 曲马多 术后疼痛 中国人群 

分 类 号：R735.2[医药卫生—肿瘤]