尿苷二磷酸葡萄糖醛酸转移酶1A9-1818T〉C单核苷酸多态性对乳腺手术患者异丙酚镇静效应的影响  

Effects of UGT1A9 - 1818T 〉 C single nucleotide polymorphism on sedation with propofol

作　　者：田丹丹[1] 任燕伶[1] 张莉蓉[2] 郜娜[3] 张卫[1] 阚全程[4] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052 [2]郑州大学基础医学院药理学教研室 [3]郑州大学基础医学院临床药理学教研室 [4]郑州大学第一附属医院临床药理基地河南省高等学校临床医学重点学科开放实验室

出　　处：《中华实验外科杂志》2013年第7期1504-1506,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（81171060/H0903）

摘　　要：目的观察尿苷二磷酸葡萄糖醛酸转移酶（UGTs）1A9—1818T〉C（UGT1A9—1818T〉C）单核苷酸多态性对乳腺手术患者异丙酚镇静效应的影响。方法择期全麻下行良性乳腺肿块切除术的女性患者150例，年龄20—50岁，体质量50～70kg，ASAI或Ⅱ级。术前采用基因测序技术进行UGT1A9—1818T〉C单核苷酸多态性位点的检测，根据基因型将患者分成野生纯合子（T／T）组、突变杂合子（T／C）组和突变纯合子（C／C）组。麻醉诱导和维持时均采用靶控输注（TCI）异丙酚，血浆靶浓度为3mg／L。记录患者停止输注异丙酚至警觉一镇静（OAA／S）评分达4分的时间，此时的脑电双频谱指数（BIS）值和异丙酚效应室浓度；BIS值升至80的时间及此时异丙酚效应室浓度。结果野生纯合组50例、突变杂合组77例和突变纯合组23例，等位基因频率T为59％，C为41％。异丙酚镇静效应存在较大的个体差异；3组患者OAA／S评分达4分的时间、BIS值、异丙酚效应室浓度和BIS值升至80的时间、异丙酚效应室浓度比较差异无统计学意义（P〉0．05）。结论UGT1A9—1818T〉C单核苷酸多态性不是引起异丙酚镇静效应个体差异的遗传因素。Objective To investigate the effects of UGT1A9 - 1818T 〉 C single nucleotide poly- morphism on sedation with propofol. Methods 150 ASA I or ]] female patients, aged 20-50 years, scheduled for elective excision of benign breast lumps under general anesthesia, were enrolled in this stud- y. The polymorphic sites of the UGT1A9 - 1818T 〉 C allele were analyzed by using polymerase chain reac- tion and gene sequencing technology. The patients were assigned to one of 3 groups according to their geno- types ： wild homozygote group, mutation heterozygote group and mutation homozygote group. Anesthesia was induced by propofol target controlled infusion （TCI） with serum concentration of 3 mg/L, until the patients lost consciousness, intravenous remifentanil and cis-atracurium. The LMA and mechanical ventilation were recorded. Anesthesia was maintained by propofol TCI （3 rag/L） , remifentanil continuous infusion, inter- mittent injection of cis-atracurium. The time, effect-site concentration and bispectral index （BIS） values were recorded when the OAA/S of patients was 4 after stopping the infusion of propofol, and the time and effect-site concentration were recorded when BIS value was 80. Sedation effects of propofol among all groups were compared by using ANOVA. Results There was large individual differences in the propofol sedative effects, but no significant difference was found among the three groups. Conclusion UGT1A9 - 1818T 〉 C SNP site is not the genetic factor that contributing to the individual variation in propofol seda- tion effects.

关 键 词：异丙酚 尿苷二磷酸葡醛酸转移酶 单核苷酸多态性 靶控输注 

分 类 号：R614[医药卫生—麻醉学]