难治性精神分裂症患者多巴胺D1受体基因多态性对氯氮平疗效的影响  

Effects of DRD1 polymorphisms on response to clozapine in resistant schizophrenic patients

作　　者：谢国军[1] 陈家强[1] 黎雪松[1] 彭艳[2] 王晓娟[2] 

机构地区：[1]佛山市第三人民医院,佛山528041 [2]佛山科学技术学院医学院检验与药学系

出　　处：《中华行为医学与脑科学杂志》2012年第3期241-243,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：广东省科技计划项目（20098030801372）

摘　　要：目的探讨难治性精神分裂症患者多巴胺受体D1（dopaminereceptorD1，DRDl）基因多态性对氯氮平治疗效果的影响。方法154例难治性精神分裂症患者使用氯氮平治疗8周，以PANSS量表评定疗效；以SNaPshot单核苷酸多态性（SingleNucleotidePolymorphism，SNP）技术检测DRDl基因rs265981、rs4532、rs686和rs265976多态性。结果氯氮平总疗效有效组（88例）与无效组（66例）相比，rs265981基因型、等位基因及rs265976基因型的分布差异均具有统计学意义（X^2=10．215，P=0．004；X^2=4．082，P=0．041；X^2=14．083，P=0．007）。氯氮平改善阴性症状有效组（58例）与无效组（96例）相比，rs265976基因型A／A、A／C、C／C的分布差异有统计学意义（X^2=9．805，P=0．046）。结论DRD1基因rs265981和rs265976多态性可能与氯氮平治疗难治性精神分裂症的临床疗效有关，rs265981基因型T／T、等位基因T和rs265976基因型A／A是氯氮平总体疗效好的预测因子；rs265976基因型A／A是氯氮平阴性症状疗效好的预测因子。Objective To investigate the effects of DRD1 rs265981 ,rs4532,rs686 and rs265976 polymorphisms on response to clozapine in resistant schizophrenic patients. Methods DRD1 genotype was determined by SNaPshot SNP technique for 154 patients with resistant schizophrenia. Clinical symptoms were evaluated by Positive and Negative Syndrome Scale （PANSS）,and the responder was defined as a reduction of 50% on PANSS score from baseline after the patients were administered orally elozapine for 8 weeks. Results The frequencies of rs265981 genotypes, alleles and rs265976 genotypes had significant differences between clozapine responder group （ 88 cases ） and nonresponder group （ 66 cases ） in total clinical efficacy （ X^2 = 10.215, P = 0. 004 ; X^2 = 4. 082, P =0.041;X^2=14. 083, P = 0. 007）. The frequencies of rs265976 genotypes had significant differences between clozapine response （ 58 cases） and nonresponse （ 96 cases） to negative symptom （ X^2 = 9. 805, P = 0.046 ）. Conclusion The polymorphisms of DRD1 gene rs265981 and rs265976 may relate with clinical response to elozapine in resistant schizophrenias, rs265981 T/T,allele T and rs265976 genotype A/A are likely to be predictive factors to the improvement of total elozapine therapeutic effects, rs265976 genotype A/A are likely to be predictive factors of negative symptom with treatment of elozapine.

关 键 词：难治性精神分裂症 多巴胺受体D1 多态性 氯氮平 

分 类 号：R749.3[医药卫生—神经病学与精神病学]