药物代谢相关基因多态性对抑郁型双相情感障碍治疗的指导作用  

The guiding role of polymorphisms on drug metabolism-related genes in the treatment of depressive bipolar disorder

作　　者：陈思宇 续慧蕾 任季冬 袁旦 蔡燕[3] CHEN Siyu;XU Huilei;REN Jidong;YUAN Dan;CAI Yan(Department of Psychiatry,Nanchong Psychosomtic Hospital,Nanchong,Sichuan 637700,China;Nanchong Cellmed Clinical Laboratory,Nanchong,Sichuan 637700,China;Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan,637700,China)

机构地区：[1]南充市身心医院精神科,四川南充637700 [2]南充赛尔医学检验所,四川南充637700 [3]川北医学院附属医院检验科,四川南充637700

出　　处：《现代医药卫生》2021年第11期1797-1799,共3页Journal of Modern Medicine & Health

基　　金：南充市研发基金项目(18YFZJ0064)。

摘　　要：目的根据药物基因检测结果,调整双相情感障碍患者的治疗方案,探讨基因检测对个体化治疗的指导意义。方法选择2019年11月至2020年6月在南充市身心医院就诊的BP患者76例作为研究对象,将其分为研究组36例,对照组40例。采集研究组患者外周血进行药物相关基因检测,根据检测结果调整用药方案,对照组采用常规治疗。疗程结束后比较两组总有效率,并在不同时间段比较两组汉密尔顿抑郁量表(HAMD)评分、临床疗效总评量表(CGI)评分、不良反应量表(TESS)评分。结果疗程结束后,两组总有效率比较,差异无统计学意义(χ^(2)=0.28,P>0.05)。研究组HAMD评分在治疗第4周时低于对照组,CGI评分在治疗第6周时低于对照组,差异均有统计学意义(P<0.05)。研究组不良反应发生率低于对照组,差异有统计学意义(χ^(2)=4.12,P<0.05)。结论根据药物基因检测结果制订治疗方案,能更好地控制患者的症状,降低药物不良反应发生率。Objective The treatment plan of patients with bipolar disorder was adjusted to explore the guiding role of genetic testing for individual therapy according to the results of pharmacogenetic testing.Methods 76 patients with BP who were treated in Nanchong Psychosomatic Hospital from November 2019 to June 2020 were selected as the research subjects.They were divided into study group(n=36)and control group(n=40).The peripheral blood of the patients in the study group was collected for metabolism-related gene testing,and the treatment plan was adjusted according to the test results,however the control group received routine treatment.After the end of treatment,the total effective rate of the two groups was compared,and the hamilton depression scale(HAMD)score,the clinical global impression(CGI)score,and the treatment emergent symptom scale(TESS)score were compared in different periods.Results Total effective rate of two groups had no statistical difference(χ^(2)=0.28,P>0.05)after the end of treatment.HAMD score of the study group was lower than that of the control group at the fourth week,CGI score was lower than that of the control group at the sixth week(P<0.05).The study group had a lower incidence of adverse reactions to the control group(χ^(2)=4.12,P<0.05).Conclusion The treatment plan was developed based on the test results,which can better control the symptoms of patients and significantly reduce the toxic side effects of drug therapy.

关 键 词：双相情感障碍 CYP2D6 CYP2C19 CYP3A5 基因检测 个体化治疗 

分 类 号：R749.41[医药卫生—神经病学与精神病学]