中国西北地区汉族扁桃体/腺样体手术患儿阿片类药物相关基因多态性的分布  

Distribution of opioid related gene polymorphisms in Han children undergoing tonsillar adenoidectomy in Northwest China

作　　者：杨玉峰 吴志新 李姣阳 孟繁思 曾毅 Yang Yufeng;Wu Zhixin;Li Jiaoyang;Meng Fansi;Zeng Yi(Department of Anesthesiology and Perioperative Medicine,Xijing Hospital,Air Force Medical University,Xi'an 710032,China;Depart-ment of Anesthesiology,Xi'an People's Hospital,Xi'an 710004,China)

机构地区：[1]空军军医大学西京医院麻醉与围术期医学科,西安710032 [2]西安市人民医院麻醉科,710004

出　　处：《国际麻醉学与复苏杂志》2020年第12期1163-1165,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：目的对接受扁桃体/腺样体手术的中国西北地区汉族患儿μ‑阿片受体基因(μ‑opioid receptor,OPRM1)、细胞色素氧化酶P450超家族(cytochrome P450 proteins,CYP)3A4*1G、CYP3A4*18B和ATP结合盒B亚家族成员1转运蛋白(ATP‑binding cassette subfamily B member 1 transporte,ABCB1)的基因型种类进行分析,明确与镇痛相关的基因突变率。方法选择西京医院2016年9月—2019年9月收治的籍贯为中国西北地区(陕西、甘肃、宁夏、青海、新疆)的行扁桃体/腺样体手术的汉族患儿513例,3~12岁,男337例,女176例,对其OPRM1、CYP3A4*1G、CYP3A4*18B和ABCB1基因多态性检测结果进行回顾分析。结果OPRM1(118A>G)突变杂合子AG型的占比为42.88%,突变纯合子GG型的占比为9.55%。CYP3A4*1G的CC、TT、TC的占比分别为54.58%、5.07%、40.35%。CYP3A4*18B杂合子AA型的占比为99.03%,AG型的占比为0.97%。AB‑CB1的CC、TT、CT的占比分别为32.94%、24.37%、42.69%。男性和女性各基因型分布差异无统计学意义(P>0.05)。结论中国西北地区汉族扁桃体/腺样体手术患儿中与芬太尼等阿片类药物相关的4个基因位点中有3个突变率较高,提示基因位点突变的测定具有指导临床麻醉用药的重要研究价值。Objective To review the genotypes ofμ‑opioid receptor(OPRM1),cytochrome P450 proteins(CYP)3A4*1G,CYP3A4*18B and ATP‑binding cassette subfamily B member 1 transporter(ABCB1)in children undergoing adenoid tonsillectomy in Northwest China and to identify the gene mutation rates related to analgesia.Methods From September 2016 to October 2019,513 kids(337 males and 176 females)with tonsillar adenoidectomy in Northwest China(Shaanxi,Gansu,Ningxia,Qinghai,Xinjiang)were enrolled in Xijing Hospital.The detection results of OPRM1,CYP3A4*1G,CYP3A4*18B and ABCB1 gene polymorphisms were re‑viewed.Results The proportion of OPRM1(118A>G)mutant heterozygote AG type was 42.88%while the proportion of mutant ho‑mozygote GG type was 9.55%.The percentages of CC,TT and TC in CYP3A4*1G were 54.58%,5.07%,40.35%respectively.The pro‑portion of CYP3A4*18B heterozygote AA type and AG type was 99.03%and 0.97%respectively.The percentages of CC,TT and CT in ABCB1 were 32.94%,24.37%,42.69%respectively.There was no significant difference between male and female in the distribution of genotypes(P>0.05).Conclusions Three of the four gene loci related to opioid drugs,such as fentanyl,have high mutation rates in children undergoing adenoid tonsillectomy in Han nationality of Northwest China,suggesting that the determination of gene site muta‑tion has important research value in guiding clinical anesthetic use.

关 键 词：中国西北地区 汉族儿童 基因多态性 阿片药物 

分 类 号：R766.9[医药卫生—耳鼻咽喉科] R726.1[医药卫生—临床医学]