COMT V158M基因多态性对术后患者舒芬太尼镇痛效果的影响  

INFLUENCE OF COMT V158M POLYMORPHISM ON THE ANALGESIC EFFECT OF SUFENTANIL IN POSTOPERATIVE PATIENTS

作　　者：张洁[1] 张雪莹 夏婧[1] 梁永新[1] 褚海辰[1] ZHANG Jie;ZHANG Xueying;XIA Jing;LIANG Yongxin;CHU Haichen(Department of Anesthesiology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院麻醉科

出　　处：《精准医学杂志》2019年第6期503-505,共3页Journal of Precision Medicine

基　　金：国家自然科学基金项目资助（8187050711）

摘　　要：目的 评价儿茶酚氧位甲基转移酶COMT V158 M基因多态性对术后患者舒芬太尼镇痛效果的影响。方法 选择2017年11月-2018年10月拟行全身麻醉下胸腔镜肺叶切除术患者100例,年龄18~60岁,ASA分级Ⅱ或Ⅲ级,术前对基因突变性进行检测,并按照基因型分为野生型纯合子组(VV组)、突变型杂合子组(VM组)和突变型纯合子组(MM组)。术后使用舒芬太尼患者自控静脉镇痛(PCIA)。记录患者术后24与48h时视觉模拟评分法(VAS)评分、术后舒芬太尼用量和术后24h睡眠质量评分和状态特质焦虑量评分。结果 与VV及VM组相比,MM组术后24、48h时VAS评分和舒芬太尼用量明显减低或减少(F=4.099~7.722,P<0.05);三组睡眠质量评分及状态特质焦虑量表评分比较差异无统计学意义(P>0.05)。结论 COMT V158 M基因多态性可能是舒芬太尼术后患者镇痛效果不同的机制之一。Objective To evaluate the influence of catechol-O-methyl transferase COMT V158M polymorphism on the analgesic effect of sufentanil in postoperative patients.Methods This study included 100 American Society of Anesthesiologists physical statusⅡorⅢpatient aged 18-60 years,who planned to undergo thoracoscopic lobectomy under general anesthesia from November 2017 to October 2018.According to the results of gene mutation detection conducted before operation,these patients were divided into wild-type homozygote group(VV group),mutant heterozygote(VM group),and mutant homozygote group(MM group).Sufentanil was used for patient-controlled intravenous analgesia postoperatively.Visual Analogue Scale(VAS)scores at 24 and 48 h after operation,postoperative sufentanil dose,and sleep quality score and State-Trait Anxiety score at 24 h after operation were recorded.Results Compared with the VV group and VM group,the MM group had significantly reduced VAS scores at 24 and 48 h after operation and postoperative sufentanil dose(F=4.099-7.722,P<0.05).There were no significant differences in sleep quality score and State-Trait Anxiety score between the three groups(P>0.05).Conclusion COMT V158M polymorphism may be one of the factors that account for the difference in the analgesic effect of sufentanil in postoperative patients.

关 键 词：多态性 单核苷酸 儿茶酚O-甲基转移酶 舒芬太尼 镇痛 

分 类 号：R394.3[医药卫生—医学遗传学] R614[医药卫生—基础医学]