5-羟色胺2A受体基因多态性与帕利哌酮治疗精神分裂症临床效果的关系  

Association between polymorphism of 5-hydroxytryptamine 2A receptor gene and the clinical efficacy of paliperidone in schizophrenia

作　　者：熊子珺 李从荣[2] 李海云 骆名艳 金玲芝 贺楚梅 

机构地区：[1]武汉大学人民医院生物医学工程,武汉市430060 [2]武汉大学人民医院检验科,武汉市430060 [3]湖北省武汉市武东医院精神科,武汉市430084

出　　处：《广西医学》2017年第1期26-30,34,共6页Guangxi Medical Journal

基　　金：湖北省卫生和计划生育委员会科研项目(WJ2015HB024)

摘　　要：目的探讨5-羟色胺2A受体(5-HT2AR)基因T102C、A-1438G多态性与帕利哌酮治疗精神分裂症临床效果的关系。方法选择112例首发精神分裂症患者,检测外周血5-HT2AR基因T102C、A-1438G并进行基因分型,按5-HT2AR基因T102C、A-1438G多态性分组。所有患者均给予帕利哌酮治疗,在治疗前和治疗1个月后,采用阳性和阴性症状评定量表(PANSS)评估临床疗效,计算PANSS评分的减分率。结果 5-HT2AR基因T102C基因型C/C共14例(C/C组)、T/C型60例(T/C组)、T/T型38例(T/T组);5-HT2AR基因A-1438G基因型A/A型70例(A/A组)、A/G型26例(A/G组)、G/G型16例(G/G型)。治疗1个月后,5-HT2AR基因T102C、A-1438G各基因型组患者PANSS的阳性症状评分、阴性症状评分、一般病理评分及总分均较治疗前下降(P<0.05)。5-HT2AR基因T102C C/C基因型患者一般病理评分的减分率低于T/C、T/T基因型(P<0.05),5-HTR2AR基因A-1438G G/G基因型患者阴性症状评分的减分率低于A/A、A/G基因型(P<0.05)。结论帕利哌酮治疗5-HT2AR基因的各个基因亚型的精神分裂症患者均有效,但是对于5-HT2AR基因T102C C/C基因型患者、A-1438G G/G基因型患者治疗效果比较差。Objective To explore the association between the polymorphisms of 5-hydroxytryptamine 2A receptor （5-HT2AR） gene and the clinical efficacy of paliperidone in schizophrenia. Methods A total of 112 patients with first episode schizophrenia were selected. 5-HT2AR gene T102C and A-1438G of peripheral blood were detected, and genotyping was conducted. The patients were grouped according to the polymorphisms of 5-HT2AR gene T102C and A-1438G. All patients were treated with paliperidone. Before treatment and after one month of treatment, positive and negative syndrome scale （PANSS） was used to assess the clinical efficacy. The reduction rate of PANSS score was calculated. Results Genotype C/C （ C/C group） , T/C （ T/C group ） , and T/T （ T/T group ） of 5-HT2AR gene T102C were found in 14,60, and 38 cases, respectively. Genotype A/A （ A/A group） , A/G （ A/G group） , and G/G （ G/G group ） of 5-HT2AR gene A-1438G were found in 70,26, and 16 cases ,respectively. After 1 month of treatment, the scores of positive symptom, negative symptom, general pathology, and total score in each genotype group of 5-HT2AR gene TI02C and A-1438G decreased compared to the scores before the treatment（P 〈0.05）. The reduction rate of the general pathology scale in patients with genotype C/C of 5-HT2AR gene T102C was lower than that in patients with genotype T/C or T/T（P 〈 0.05 ）. The reduction rate of the negative symptom score in patients with genotype G/G of 5-HT2AR gene T102C was lower than that in patients with genotype A/A or A/G（ P 〈 0.05 ）. Conclusion Paliperidone is effective for asschizophrenia patients with various genotypes of 5-HT2AR gene ,but is less effective for the patients with genotype C/C of 5-HT2AR gene T102C or genotype G/G of A-1438G

关 键 词：精神分裂症 5-羟色胺2A受体 基因多态性 帕利哌酮 疗效 

分 类 号：R749.3[医药卫生—神经病学与精神病学]