细胞色素氧化酶CYP1A2~*C基因多态性对罗哌卡因麻醉效应的影响  

Cytochrome oxidase CYP1A2~*C gene polymorphism influencing anesthesia effect of ropivacaine hydrochlorid

作　　者：李珍[1] 李爱媛[1] 

机构地区：[1]湖南省妇幼保健院麻醉科,湖南长沙410008

出　　处：《中国医学工程》2017年第5期10-14,共5页China Medical Engineering

基　　金：湖南省科技厅一般项目(2012SK3262)

摘　　要：目的探讨细胞色素氧化酶CYP1A2~*C基因多态性对罗哌卡因麻醉中效应的影响,为罗哌卡因在个体化用药中提供参考。方法 200例开腹行子宫肌瘤剥离或子宫全切的患者麻醉前抽血行CYP1A2~*C基因分型。患者入室后常规心电监护,开放静脉通道输液,予以罗哌卡因腰硬联合麻醉,记录患者的麻醉感觉阻滞起效时间、最高感觉平面固定时间、运动阻滞起效时间、运动阻滞达3分所需时间、肌松效果、低血压、心动过缓和恶心呕吐发生率。结果本实验组患者细胞色素氧化酶CYP1A2~*C 3种基因型及基因频数:AA型10例(5.0%)、GA型70例(35.0%)、GG型120例(60.0%)。AA型、GA型、GG型3组患者罗哌卡因的麻醉感觉阻滞起效时间、最高感觉平面固定时间、运动阻滞起效时间、运动阻滞达3分所需时间、肌松效果和恶心呕吐发生率差异无统计学意义(P>0.05);GA型患者的低血压、心动过缓发生率明显高于AA型、GG型,差异具有统计学意义(P<0.05),而GG型和GA型患者之间差异无统计学意义(P>0.05)。结论CYP1A2~*C基因多态性在罗哌卡因临床麻醉中对患者麻醉感觉阻滞、运动阻滞、肌松效果和恶心呕吐发生率差异无统计学意义,而对低血压、心动过缓发生率有明显影响。[Objective] To identify how cytochrome oxidase CYP1A2＊C gene polymorphism influences the anesthesia effect of ropivacaine hydrochloride, and to provide some instructions of its personalized medicine for clinic application. [Methods] Blood test was taken to detect gene types of CYP 1A2＊C before the patients were narcotized, who would undergo the tumor peeling or hysterectomy because of hysteromyoma. The electrocardiograph monitoring and venous transfusion were prepared after patients were carried to the operating room. The onset time of sensory and motor block, degree of motor block, the height of sensory, muscle relaxation, low blood pressure, bradycardia, and the incidence of nausea and vomiting, etc. were recorded after combined spinal epidural anesthesia （CSEA） were applied. [Results] The three groups were divided into AA （10 examples, 5.0%）, GA （70 examples, 35.0%）, GG （120 examples, 60.0%） by the gene types of CYP1A2＊C. There were no significant differences among three groups in the following indices such as the onset time of sensory and motor block, degree of motor block, the height of sensory, muscle relaxation, and the incidence of nausea and vomiting. The incidence of low blood pressure and bradycardia was significantly higher in the group GA than group AA or group GG （P 〈0.05）, while there was no significant difference between the latter two. [Conclusion] In patients undergoing anesthesia with ropivacaine, the influence of gene polymorphism of CYP 1A2＊C on the incidence of low blood pressure and bradycardia was significant, while the influence on the onset time of sensory, motor block, degree of motor block, the height of sensory, muscle relaxation, and the incidence of nausea and vomitin~ was not significant.

关 键 词：CYP1A2＊1C 罗哌卡因 基因多态性 临床麻醉 

分 类 号：R977.3[医药卫生—药品]