ABCB1基因多态性与癌痛感知及癌痛病人阿片需求量的关联性分析  

ASSOCIATION OF SINGLE NUCLEOTIDE POLYMORPHISMS OF ABCB1 WITH PAIN PERCEPTION AND OPIOID REQUIREMENTS IN PATIENTS WITH CANCER PAIN

作　　者：朱敏[1,2] 潘志强[1,2] 张璐[1,2] 张慧[1,2] 陈立平 许恒 申文[1,2,3] 

机构地区：[1]江苏省麻醉学重点实验室,徐州221000 [2]江苏省麻醉与镇痛应用技术重点实验室,徐州221000 [3]徐州医科大学附属医院麻醉与疼痛科,徐州221000

出　　处：《中国疼痛医学杂志》2017年第6期426-433,共8页Chinese Journal of Pain Medicine

基　　金：省重点研发计划社会发展一面上项目(BE2015626)

摘　　要：目的:探讨ABCB1 C3435T、G2677A/T与癌痛病人疼痛感知的相关性,并研究ABCB1C3435T、G2677A/T对癌痛病人阿片需求量的影响。方法:应用三维聚丙烯酰胺凝DNA芯片技术检测148例癌痛病人和105例无疼痛恶性肿瘤病人的ABCB1 C3435T、G2677A/T基因分型。应用卡方检验比较不同癌痛程度病人间基因型分布,应用两样本t检验、非参数检验及单因素方差分析比较不同基因型病人疼痛评分和24 h-阿片需求量。结果:253例病人中3435T、2677A/T等位基因频率分别为42.9%、9.1%和40.5%;ABCB1 C3435T、G2677A/T基因分型在癌痛组和无痛组间无差异(P=0.371和0.507);不同C3435T、G2677A/T基因分型病人的疼痛程度及疼痛数字评分(numerical rating scale,NRS)没有差异;ABCB1 C3435T、G2677A/T不同基因型癌痛组病人间24 h-阿片药物需求量没有统计学差异(P>0.05);TT-TT单倍体型病人体重-24 h-阿片剂量、体重-体表面积-24 h-阿片需求量明显低于CG-CG、CG-TT单倍体型(P=0.043和0.015)。结论:尚不能认为ABCB1 C3435T、G2677A/T影响癌痛病人的疼痛感知,但ABCB1 C3435T、G2677A/T可能会影响癌痛病人24 h-阿片需求量,可能是阿片用量个体差异的因素之一。Objective： To investigate the association of the genotypes of ABCB1 C3435 T and G2677A/T with pain perception and opioid requirements in cancer patients. Methods： A total of 148 cancer patients with pain and 105 cancer patients without pain were included to determine their genotypes for the ABCB1 C3435 T and G2677A/T on a three-dimensional polyacrylamide gel-based DNA microarray. Chi-square test was used to compare the genotype distribution between groups with different pain intensities. T-test, nonparametric tests and chi-square test were used to compare pain scores with 24 hour opioid requirements between groups with different genotypes. Results： In the 253 subjects, the frequency of variant 3435 T and 2677A/T allele was 42.9%, 9.1%, and 40.5%, respectively. No significant difference in the genotype distribution of ABCB1 C3435 T and G2677A/T was observed between cancer pain group and control group（P = 0.371 and 0.507）. The genotypes of ABCB1 C3435 T and G2677A/T were not associated with the intensities of pain and NRS score in cancer patients. No significant differences were observed between ABCB1 C3435 T and G2677A/T genotypes with opioids consumptions, even though all three calculation methods of drug doses were used（P 〉 0.05）. Compared with the CG-CG and CG-TT haplotype, patients with TT-TT haplotype received lower weight-adjusted-24h-opioids and weight-surface area-adjusted-24h-opioids（P = 0.043 and 0.015）. Conclusions： Evidence does not support that the SNPs of ABCB1 C3435 T and G2677A/T influence the pain perception in Chinese cancer patients. The ABCB1 C3435 T and G2677A/T may affect the opioid requirements in cancer pain patients, which may be a key contributor for the inter-individual variability in opioid consumption.

关 键 词：单核苷酸多态性 癌痛 阿片需求量 ABCB1基因 癌痛感知 癌痛治疗 

分 类 号：R730.5[医药卫生—肿瘤]