文拉法辛缓释剂治疗广泛性焦虑障碍患者的疗效与5-羟色胺2A受体基因多态性的相关性研究  

The relationship between 5-serotonin 2A receptor gene polymorphism and treatment response to venlafaxine in patients with generalized anxiety disorder

作　　者：崔力军[1] 朱洁琳[1] 沈仲夏[1] 胡瑾瑾[2] 宋娟芳[2] 沈鑫华[3] CUI Li-jun;ZHU Jie-lin;SHEN Zhong-xia;HU Jin-jin;SONG Juan-fang;SHEN Xin-hua(The Third People Hosptial of Huzhou,Psychiatric Center Laboratory,Clinical Laboratory,Psychosomatic Department,Huzhou313000,China)

机构地区：[1]湖州市第三人民医院精神医学重点实验室,浙江313000 [2]湖州市第三人民医院检验科 [3]湖州市第三人民医院心身科

出　　处：《临床精神医学杂志》2018年第6期378-381,共4页Journal of Clinical Psychiatry

基　　金：2015年浙江省医药卫生一般项目立项(2105KYA213)

摘　　要：目的:探讨文拉法辛治疗广泛性焦虑障碍(GAD)的疗效及与5-羟色胺2A受体(5-HTR2A)基因多态性的关系。方法:120例GAD患者经文拉法辛治疗6周,应用汉密尔顿焦虑量表(HAMA)于基线期及治疗后的2、4、6周末进行疗效评价,按照HAMA减分率≥50%和<50%分为有效组和无效组;采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术分析患者5-HTR2A(T102C)基因多态性。结果:随着文拉法辛治疗时间延长,与基线相比GAD患者HAMA评分减分及减分率均明显增加,治疗6周,治疗有效率达到79%(93/25例)。治疗4周和6周,CC基因型HAMA评分明显低于TT型和TC型(F=3. 44,P=0. 038; F=4. 585,P=0. 014),HAMA减分率明显高于TT型和TC型(F=5. 655,P=0. 006; F=6. 860,P=0. 002)。治疗6周末,文拉法辛治疗有效组CC基因型及C等位基因频率明显高于无效组(χ2=11. 197,P=0. 004;χ2=6. 375,P=0. 012)。结论:文拉法辛缓释剂治疗GAD的疗效与5-HTR2A(T102C)基因多态性相关;相比TT和TC型,CC型起效快、疗效佳。Objective:To explore the relationship between5-serotonin2A receptor gene(T102C)polymorphism and treatment responses to venlafaxine in patients with generalized anxiety disorder(GAD).Method:One hundred and twenty GAD patients who met the DSM-IV criteria were recurited and treated with venlafaxine for six weeks.All patients were assessed by Hamilton anxiety scale(HAMA)at baseline,second,fourth and sixth week during treatment.Patients were divided into responder and non-responder groups according to the HAMA reduction rate of50%.The genetypes and allele frequencies of5-HTR2A gene polymorphism were examined with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Results:As venlafaxine treatment contunued,both the HAMA score decrease and reduction rate grew significantly during treatment period compared with that at baseline.The effective rate of venlafaxine was79%at the end of the treatment.HAMA scores of patients with CC genotypes were significantly lower than patients with TT genotypes and patients with TC genotypes(F=3.44,P=0.038;F=4.585,P=0.014),while the HAMA reduction rate of patients with CC genotypes were significantly higher than patients with TT and TC genotypes(F=5.655,P=0.006;F=6.860,P=0.002)at fourth and sixth week.There were significantly frequency differences of CC genotypes and C alleles between the responder and non-responder patients at sixth week(χ^2=11.197,P=0.004;χ^2=6.375,P=0.012).Conclusion:Venlafaxine treatment efficacy may be associated with polymorphisms of5-HTR2A(T102C)genes in patients with generalized anxiety.Patients with CC genotypes have earlier and better response compared with patients with TT and TC genotypes.

关 键 词：广泛性焦虑障碍 文拉法辛 5-羟色胺2A受体基因 

分 类 号：R749.7[医药卫生—神经病学与精神病学]