CHRNA1和ORM1基因多态性对维库溴铵肌松效应的影响  

Effect of CHRNA1 and ORM1 Gene Polymorphism on Neuromuscular Blockade of Vecuronium

作　　者：段宏伟 吴海星[2] 吴一鸣 宋颖 高鸿[2] 马端 

机构地区：[1]复旦大学附属浦东医院,上海201300 [2]贵州医科大学麻醉学系,贵州贵阳550004 [3]复旦大学生物医学研究院,上海200032

出　　处：《医学临床研究》2017年第12期2289-2291,2295,共4页Journal of Clinical Research

基　　金：上海市卫生和计划生育委员会基金（编号;20134272）

摘　　要：【目的】探讨CHRNA1和ORM1基因多态性对维库溴铵肌松效应的影响。【方法】选取ASA Ⅰ-Ⅱ级、年龄18～65岁，择期全麻下拟行乳腺包块切除的女性患者儿4例，术前采集外周静脉血5mL，采用3730XL DNA测序仪（Applied Biosystems，USA）直接测序。麻醉诱导期间给予2ED95（0.1mg/kg）维库溴铵，用TOF-Watch加速度仪进行肌肉松弛监测，采用4个成串刺激（train of four，TOF）方式监测拇内收肌的收缩反应。观察起效时间、时效、体内作用时间、恢复指数、TOF比率恢复到25%的时间。按照肌松监测指标的90%置信区间纳入标准，选取107例患者其中的12例，对CHRNA1全外显子、rs16862847和ORM1（A113G）进行测序。【结果】12例患者CHRNA1基因的全外显子、rs16862847SNP位点和ORM1 A113G测序结果显示CHRNA1基因的全外显子、rs16862847均未发现突变。ORM1发现7例A113G杂舍子突变（ORM1＊F/＊S），5例未发现突变（ORM1＊F/＊F）。【结论】ORM1 A113G基因多态性可能在一定程度上影响维库溴铵的肌松效应，其可能机制需进一步研究。[Objective] To investigate the effect of CHRNA1 and ORM1 gene polymorphism on neuromuscular blockade of vecuronium.[Metbods] A total of 114 women patients with （ASA Ⅰ-Ⅱ grade , 18 - 65 years of age ,who underwent breast lump removal under general anesthesia） were selected .The peripheral venous blood was collected 5 mL before operation and directly sequenced by 3730 XL DNA sequencer（Applied Biosystems,USA）. 2ED95 （ 0.1 mg / kg ） of vecuronium bromide was administered during anesthesia induction. The muscle relaxation monitoring was carried out by the TOF--Watch accelerometer. The contractile response of adductor pollicis muscle was monitored by train of four（TOF）stimulation. The onset time, time of action, time of action in vivo, recovery index and time from TOF ratio to 25% were observed. The 90 % confidence interval according to the neuromuscular blockade monitoring index was included in the standard through which 12 were selected of the 107 patients. CHRNA1 total exons, rs16862847 and ORM1 （A113G） were sequenced. [Results]The total exon of CHRNA1 gene , rs16862847SNP site and ORM1 All3G sequen- cing in 12 patients showed no mutation was found in the total exon Of CHRNA1 gene and rs16862847. ORM1 found 7 cases of Al13G heterozygote mutation （ORM1 ＊ F/＊ S）, 5 undiscovered mutations （ ORM1 ＊ F / ＊ F ）.[Conclusion] ORM1 A113G gene polymorphism may affect the neuromuscular blockade of vecuronium to a certain extent , yet the possible mechanisms need to be further studied,

关 键 词：维库溴铵 肌松弛药 中枢性 多态现象 遗传 肌松弛 

分 类 号：R96[医药卫生—药理学]