CYP2D6基因多态性与利培酮治疗精神分裂症的相关性研究  

A related study of CYP2D6 gene polymorphism and risperidone treatment in patients with schizophrenia

作　　者：于晓东[1] 杨楹[1] 刘增训[1] 李宪伟[1] 滕伟钰[1] 王旸[1,2] 王汝展 YU Xiaodong;YANG Ying;LIU Zengxun(Shandong Mental Health Center,Jinan 250014,China)

机构地区：[1]山东省精神卫生中心,山东济南250014 [2]山东大学临床医学院精神病学教研室

出　　处：《精神医学杂志》2020年第3期209-213,共5页Journal of Psychiatry

基　　金：山东省医药卫生科技发展计划项目(编号:2016WS0400)。

摘　　要：目的探讨CYP2D6基因多态性与利培酮治疗精神分裂症的相关性。方法共计收集296例精神分裂症患者,并进行CYP2D6基因多态性检测。根据检测结果,将98例检测结果08CYP2D6基因检测为TT、10CYP2D6基因检测为GG、06CYP2D6基因检测为CC,基因型分析结果为*10/*10,代谢型为IM的患者视为研究组,将198例其他基因型的患者视为对照组,均应用利培酮系统治疗,共6周。在基线和治疗后第2、4、6周末使用阳性和阴性综合征量表(PANSS)、临床总体印象量表-病情严重程度(CGI-SI)、治疗中需处理的不良反应症状量表(TESS)评定疗效和安全性。结果在治疗后第6周末,研究组的利培酮用量低于对照组(P<0.05)。治疗后第4、6周末,两组CGI评分、PANSS总分及各因子分均较各自基线时降低(P<0.05)。在治疗后第2、4、6周末,研究组的TESS评分及不良反应例次数均低于对照组(P<0.05)。在治疗后第6周末,研究组的总不良反应发生率低于对照组(P<0.05)。结论CYP2D6基因多态性检测结果:08CYP2D6基因检测为TT、10CYP2D6基因检测为GG、06CYP2D6基因检测为CC、基因型分析结果为*10/*10,代谢型为IM的精神分裂症患者选用利培酮系统治疗,可取得较好的临床疗效,更低的药物治疗剂量,更高的治疗安全性。Objective To explore the relationship of CYP2D6 gene polymorphism and risperidone treatment in patients with schizophrenia.Methods A total of 296 patients with schizophrenia were selected and examined with CYP2D6 gene polymorphism.According to the results of CYP2D6 gene polymorphism,there were 98 patients with CYP2D6 gene polymorphism of TT type of 08CYP2D6,GG type of 10CYP2D6,CC type of 06CYP2D6,*10/*10 of genotype analysis,IM of metabolize type in study group and 198 patients with CYP2D6 gene polymorphism of other types in control group for 6 weeks treatment of risperidone.They were assessed with Positive and Negative Syndrome Scale(PANSS),Clinical Global Impression-Severity of Illness(CGI-SI)and Treatment Emergent Symptom Scale(TESS)at baseline,the 2 nd weekend,the 4 th weekend and the 6 th weekend of treatment.Results At the 6 th weekend of treatment,the dose of risperidone in study group was significantly lower than that in control group(P<0.05).At the 4 th and the 6 th weekends of treatment,the total scores and all factor scores of PANSS,the scores of CGI in two groups decreased significantly compared with those at baseline(P<0.05).At the 2 nd,the 4 th and the 6 th weekends of treatment,the scores of TESS and the cases of side effects in study group were all significantly lower than those in control group(P<0.05).At the 6 th weekend of treatment,the total rate of side effects in study group was significantly lower than that in control group(P<0.05).Conclusion It’s more effective and much safer for risperidone to treat the schizophrenics with CYP2D6 gene polymorphism of TT type of 08CYP2D6,GG type of 10CYP2D6,CC type of 06CYP2D6,*10/*10 of genotype analysis,IM of metabolize type with lower dose.

关 键 词：CYP2D6基因多态性 精神分裂症 利培酮 基因检测 精准治疗 

分 类 号：R749.3[医药卫生—神经病学与精神病学]