便秘型肠易激综合征的SERT基因多态性及其与患者临床疗效的关系  

Sertotonin-transporter polymorphism in constipation-predominanti irritable bowel syndrome and its influence on clinical effect of tegaserod

作　　者：张自翔[1] 谢军[1] 黄才斌[1] 廖跃光[1] 舒涛[1] 付曲波[1] 

机构地区：[1]赣南医学院第一附属医院,江西赣州341000

出　　处：《山东医药》2012年第25期16-18,共3页Shandong Medical Journal

基　　金：江西省自然科学基金项目(2008GZY0073);江西省卫生厅科技计划项目(20063157)

摘　　要：目的探讨便秘型肠易激综合征(C-IBS)5-羟色胺转运蛋白(SERT)基因多态性及其与替加色罗临床疗效的关系。方法利用PCR检测84例符合罗马Ⅲ诊断标准的C-IBS患者和103例健康对照者外周血的SERT启动子区域(5-HTTLPR)与第2内含子可变数目串联重复序列(VNTRs)两个基因多态性,对其中入选65例的C-IBS患者给予4周替加色罗6 mg、2次/d,评估治疗前后患者临床症状及便秘程度。结果 C-IBS患者L/L基因型频率比对照组明显升高(25.0%vs 7.8%,P<0.05)。治疗后C-IBS患者各基因型组替加色罗治疗的有效率有统计学差异差异,表现为总体疗效和单个症状改善S/S基因型和S/L基因型均优于L/L基因型(S/S 93.1%、S/L 70.6%、L/L 33.3%,P<0.01)。结论 SERT基因多态性可能与C-IBS相关;SERT基因多态性影响替加色罗对C-IBS患者的疗效。Objective To investigate the potential association between the serotonin reuptake transporter（SERT） pol- ymorphisms and the constipation predominant irritable bowel syndrome（C-IBS） phenotype, also to investigate the impact of SERT genotypes on the efficacy of 5-HT4 receptor agonist tegaserod in constipation predominant type patients. Methods PCR was used to detect the 5-HTI＇LPR and VNTRs polymorphisms of SERT gene in 84 patients with C-IBS confirmed with Rome 1~ criteria and 103 healthy subjects, then 61 C-IBS patients received tegaserod 6 mg twice daily for 4 weeks. Pa- tients recorded their symptoms in a diary. Efficacy was assessed by patient＇ s overall symptoms of IBS and severity of consti- pation before and after tegaserod treatment. Results There was significant difference between patients and controls on gen- otypes of the 5-HTYLPR gene （P 〈0.01 ） , and the allele frequencies of the 5-HTYLPR allele L/L genotype was signifi- cantly higher in the constipation predominant IBS （C-IBS） group than in the controls （25% vs 7.8% , P 〈 0.05 ）. The clinical responder rates of tegaserod in S/S and S/L genotypes significantly differed from those in L/L genotype （ S/S 93.1%, S/L70.6%, L/L33.3%, P〈0.01）. Conclusions The5-HTYLPRpolymorphisms of SERTgene were proba- bly associated with C-IBS. SERT gene polymorphisms influenced the efficacy of tegaserod in C-IBS patients.

关 键 词：肠易激综合征 多态性 单核苷酸 替加色罗 

分 类 号：R574.4[医药卫生—消化系统]