SCN9A基因多态性对胃癌术后疼痛的影响  

The influence of SCN9A single nucleotide polymorphism on postoperative pain of gastrectomy

作　　者：向桂芳[1] 段光友[1] 张咸伟[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,武汉430030

出　　处：《中华实验外科杂志》2013年第8期1723-1725,共3页Chinese Journal of Experimental Surgery

摘　　要：目的SCN9A基因单核苷酸多态性（SNPs）对胃癌手术术后患者疼痛敏感性的影响，寻找干预术后疼痛的靶点。方法选取胃癌手术患者232例，术前进行疼痛阈值以及疼痛耐受力检测，术后进行疼痛敏感性检测并记录术后镇痛药的使用剂量。对每位患者的SCN9A基因进行SNPs检测（3312G〉T）。比较SCN9A3312G〉T和术后疼痛敏感性以及术后镇痛药使用剂量之间的关系。结果SCN9A3312T的等位基因的患者有28例（12．1％），3312G的患者为204例（87．9％）；术后镇痛药的给药频率[（2．78±0．75）比（2．01±0．63）小时／次，P〈0．05]和给药量[（105．3±21．6）比（69．8±17．3）ml，P〈0．05]在3312G的患者明显高于3312T的患者；3312G组患者发生镇痛不良的概率高于3312T的患者（29．4％比8．6％，P〈0．05）；回归相关分析表明SCN9A在3312位的基因改变以及疼痛阈值高与术后疼痛的敏感性有较强相关性[比值比（OR）=0．12；OR=0．29]。结论SCN9A3312G〉T可以降低大型手术术后患者的疼痛敏感性。Objective To explore the role of SCNgA single nucleotide polymorphism （SNPs） in postoperative pain of gastrectomy patients and define a new target for analgesia. Methods 232 gastric cancer patients who were subjected to gastrectomy were included in this study. SCN9A 3312G 〉 T alleles in each patient were detected by genetic analysis. The preoperative pressure pain thresholds and tolerance were measured before the operation, and the incidence of inadequate analgesia and average patient-con- trolled analgesia pressing frequency and opioid consumption were recorded after operation. These variables were compared according to the SCN9A SNPs. The role of preoperative variables in postoperative inade- quate analgesia was predicted by Logistic regression analysis. Results The ratio of SCN9A 3312G 〉 T was 12. 1% （28 cases of SCN9A 3312T and rest of SCN9A 3312G）. The incidence of inadequate analgesia was higher in 3312G group than in 3312T group （29. 4% vs. 8. 6% ,P 〈0. 05）. The average patient-con- trolled analgesia pressing frequency and opioid consumption were also increased in 3312G group as compared with 3312T group [ （2. 78 ±0. 75） vs. （2. 01 ±0. 63） h/time; （105. 3 ±21.6） vs. （69. 8 ± 17. 3） ral,P 〈 0. 05 ]. SCN9A 3312G 〉 T alleles and higher pressure pain threshold predicted a lower risk of postoperative inadequate analgesia （ with an odds ratio of 0. 12 and 0. 29 respectively）. Conclusion SCN9A SNPs （3312G 〉 T alleles） was related to postoperative pain in gastrectomy patients.

关 键 词：胃癌 疼痛 SCN9A 单核苷酸多态性 

分 类 号：R735.2[医药卫生—肿瘤]