CYP450酶基因多态性对芬太尼个体化用药的影响  

Impact of CYP450 Genetic Polymorphisms on Individualized Treatment of Fentanyl

作　　者：俞高洁 陈振毅[2] YU Gaojie;CHEN Zhenyi(Postgraduate Education of Fujian Medical University,Fuzhou Fujian 350000,China;Department of Anesthesia,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361000,China)

机构地区：[1]福建医科大学研究生院,福建福州350000 [2]厦门大学附属第一医院麻醉科,福建厦门361000

出　　处：《中国卫生标准管理》2021年第2期108-111,共4页China Health Standard Management

基　　金：厦门市科技计划项目(3502Z20174069)。

摘　　要：细胞色素P450酶与90%临床药物代谢相关,已发现家族中CYP2D6、CYP3A4和CYP3A5参与芬太尼等镇痛药物的Ⅰ相代谢反应。基因多态性可影响细胞色素P450酶的活性和功能,产生明显的芬太尼药代动力学个体间差异,导致不同基因型的携带者表现出镇痛效果、安全剂量范围及毒副作用发生率的差异。芬太尼是常用的阿片类镇痛药,如何实现个体化用药给患者带来良好的治疗体验成为近年国内外重视的方向,深入研究基因多态性与芬太尼的联系有助于麻醉医师预先拟定用药剂量,平衡芬太尼用药的有效性与安全性。本文探讨了CYP2D6、CYP3A4、CYP3A5等基因多态性与芬太尼的药物代谢之间的相关性,以期提高芬太尼镇痛疗效。Cytochrome P450 enzymes are associated with 90%of clinical drug metabolism.It has been found that CYP2D6,CYP3A4 and CYP3A5 in the family are involved in phase I metabolism of analgesics such as fentanyl.Gene polymorphism can affect the activity and function of cytochrome P450 enzyme,and produce significant pharmacokinetic differences among individuals of fentanyl,leading to differences in analgesic effect,safe dose range and incidence of toxic and side effects among carriers of different genotypes.Fentanyl is a commonly used opioid analgesic,how to bring better treatment experience to patients with individual medication has become the direction of attention at home and abroad in recent years.An in-depth study of the relationship between gene polymorphism and fentanyl will help anesthesiologists to determine the dosage in advance and balance the efficacy and safety of fentanyl.This article reviews the relationship between CYP2D6,CYP3A4,CYP3A5 gene polymorphisms and drug metabolism of fentanyl,in order to improve the analgesic effect of fentanyl.

关 键 词：镇痛药 芬太尼 基因多态性 细胞色素P450 药物代谢 临床用药 

分 类 号：R971.2[医药卫生—药品]