CYP2D6基因多态性与托莫西汀治疗ADHD疗效的关联性研究进展  

Research progress of relationship between CYP2D6 gene polymorphism and therapeutic effect of tomoxetine in the treatment of ADHD

作　　者：王玉文[1] 周国岭[2] 刘艳[2] 宋明芬[3] 龙森[1] 施剑飞[4] 王泽民[1] WANG Yuwen;ZHOU Guoling;LIU Yon;SONG Mingfen;LONG Sen;SHI Jianfei;WANG Zemin(Department of Clinical Pharmacy,Hangzhou Seventh People＇s Hospital,Hangzhou 310013,China;Department of Pediatric Psychology,Hangzhou Seventh People＇s Hospital,Hangzhou 310013,China;Central Laboratory,Hangzhou Seventh People＇s Hospital,Hangzhou 310013,China;Department of Psychiatry,Hangzhou Seventh People＇s Hospital,Hangzhou 310013,China)

机构地区：[1]杭州市第七人民医院药剂科,浙江杭州310013 [2]杭州市第七人民医院儿童心理科,浙江杭州310013 [3]杭州市第七人民医院中心实验室,浙江杭州310013 [4]杭州市第七人民医院精神科,浙江杭州310013

出　　处：《中国现代医生》2018年第20期165-168,共4页China Modern Doctor

基　　金：浙江省杭州市卫生科技计划项目(2014A50);浙江省重大科技专项重大社会发展项目(2015C03054)

摘　　要：托莫西汀是目前治疗ADHD的主要药物之一,主要经细胞色素P450酶代谢,是CYP2D6酶的底物。CYP2D6酶具有显著的基因多态性,不同个体CYP2D6酶对托莫西汀代谢能力有所差异,从而影响临床治疗ADHD的效果。查阅近年来国内外相关文献,对CYP2D6基因多态性与托莫西汀治疗ADHD疗效的关联性研究进展进行归纳总结。CYP2D6基因多态性可影响托莫西汀的疗效,CYP2D6慢代谢型患者需要更高的治疗剂量,发生不良反应的风险更高。CYP2D6基因型和表型对托莫西汀体内代谢和临床疗效的影响有待于进一步深入研究,ADHD患者CYP2D6基因多态性分布的全面系统调查也有待于开展,这将有利于托莫西汀治疗ADHD个体化用药的开展。Tomoxetine is one of the main drugs for the treatment of ADHD, which is mainly matabolized by the cytoehrome P450 enzyme, and is the substrate of CYP2D6 enzyme. CYP2D6 enzyme has a significant genetic polymorphism. Different CYP2D6 enzymes vary in their ability to metabolize tomoxetine, thereby affecting the clinical efficacy of ADHD. The related literature at home and abroad in recent years is retrieved, and the research progress of the association between CYP2D6 gene polymorphism and therapeutic effect of tomoxetine on ADHD is summarized. CYP2D6 gene polymorphism can affect the efficacy of tomoxetine, and the patients with slow metabolism of CYP2D6 need higher doses. The risk of adverse reactions is higher. The effect of CYP2D6 genotype and phenotype on the metabolism and clinical efficacy of tomoxetine remains to be further studied. A comprehensive and systematic investigation of the distribution of CYP2D6 polymorphism in ADHD patients remains to be carried out. This will be beneficial to the develop- ment of individualized dosage of tomoxetine in the treatment of ADHD.

关 键 词：CYP2D6 基因多态性 托莫西汀 ADHD 

分 类 号：R749[医药卫生—神经病学与精神病学]