G211T突变与吗啡治疗癌痛有效性及安全性的相关性研究  

Study on the Correlation between G211T Mutation and the Efficacy and Safety of Morphine Treatment on Cancer Pain

作　　者：吴楠[1] 张东蕾[1] 王蕾[1] 丁年羊[1] 李婕[1] 杨扬[1] 燕丹[1] 童本定[1] 魏青[1] 

机构地区：[1]江苏省肿瘤医院,江苏南京210009

出　　处：《中国药物警戒》2017年第1期14-18,共5页Chinese Journal of Pharmacovigilance

基　　金：南京市科技发展计划(药学项目)(2012YX005)

摘　　要：目的了解癌痛患者UGT2B7基因多态性的分布频率,探讨UGT2B7*1 G211T突变与吗啡对癌痛治疗效果及不良反应的相关性。方法对中重度癌痛患者给予吗啡镇痛治疗,采用数字分级法(NRS)进行疼痛评估,记录疼痛缓解所需吗啡剂量及药品不良反应发生情况。检测癌痛患者UGT2B7*1 211位点基因型,评价UGT2B7*1 G211T突变与吗啡用量以及不良反应的相关性。结果在中国癌痛人群中,UGT2B7*1 211位点基因型的野生型(GG)频率最高(68.60%),突变杂合子(GT)频率次之(24.42%),突变纯合子型(TT)频率最低(6.98%)。UGT2B7*1 G211T突变组(即GT组+TT组)与未突变组(GG组)比较,突变组疼痛缓解所需吗啡剂量高于未突变组(P<0.05),突变组眩晕以及2级以上便秘的发生率高于未突变组(P<0.05)。结论 UGT2B7*1 G211T基因多态性与吗啡镇痛剂量及安全性存在相关性。Objective To study the distribution frequency of UGT2B7 gene polymorphism in patients with cancer pain, and evaluate the effect of UGT2B7 ＊ 1 G211 T polymorphisms on the effect and safety of morphine. Methods Patients with moderatesevere cancer pain were treated with morphine,the numerical rating scale（NRS）was used for pain evaluation. Treatment data and adverse effects were recorded and UGT2B7 gene polymorphism was detected. According to the genotype and morphine dose, the impact of UGT2B7＊1 G211 T mutation on morphine analgesia efficacy and safety were evaluated. Results There were 68.60% patients with wild-type UGT2B7＊1 G211 G, 24.42% patients with heterozygous mutation UGT2B7＊1 G211 T and 6.98% patients with homozygous mutant UGT2B7＊1 T211 T in Chinese patients with cancer pain. UGT2B7＊1 G211 T mutation group（ie group GT＋ group TT） needed higher doses of morphine than GG group（P 0.05）. Dizziness and grade 2~3 constipation happened more frequently in the UGT2B7＊1 G211 T mutation group（ie group GT＋ group TT） than the wild-type group（group GG）（ P 0.05）. Conclusion UGT2B7＊1 G211 T polymorphisms have impact on analgesic effect and safety of morphine.

关 键 词：癌痛 吗啡 UGT2B7 基因多态性 

分 类 号：R969[医药卫生—药理学]