儿茶酚胺氧位甲基转移酶Val158met基因多态性与榆林地区妇科患者术后芬太尼镇痛效应关系研究  

Relationship between COMT Val158met gene polymorphism and analgesic effect of fentanyl in gynecological postoperative patients in Yulin area

作　　者：王雄 高芳芳 贺峰[2] WANG Xiong;GAO Fangfang;HE Feng(Department of Anesthesiology,Yulin Xingyuan Hosptial,Yulin 719000,China)

机构地区：[1]榆林市星元医院麻醉科,陕西榆林719000 [2]榆林市第二医院麻醉科,陕西榆林719000

出　　处：《陕西医学杂志》2021年第8期992-994,F0003,共4页Shaanxi Medical Journal

摘　　要：目的:探究儿茶酚胺氧位甲基转移酶(COMT)Val158met基因多态性与榆林地区妇科患者术后芬太尼镇痛效应的关系。方法:选择全麻下汉族妇科手术患者121例,术后行芬太尼静脉自控镇痛(PCIA)。采集患者静脉血后,采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)测量患者COMT Val158met基因多态性,记录并分析术后48 h内PCIA芬太尼用量、血氧饱和度(SpO 2)、镇痛评分标准(Ramasay评分)及视觉模拟量表(VAS)评分。结果:AA、GA、GG基因型频率分别为19%、47.9%、33.1%;A、G等位基因频率分别为29.8%、70.2%。术后6、24、48 h,不同基因型患者SpO 2、VAS评分和Ramsay镇静评分比较差异无统计学意义(均P>0.05)。与GG基因型患者相比,AA基因型和GA基因型患者术后48 h芬太尼用量明显降低(均P<0.05)。结论:榆林地区汉族妇科患者术后芬太尼镇痛效应存在明显差异,可能与当地COMT Val158met基因多态性有关。Objective:To explore the relationship between the catecholamine oxygen methyltransferase(COMT)Val158met gene polymorphism and the analgesic effect of fentanyl in gynecological postoperative patients in Yulin area.Methods:A total of 121 Han nationality patients underwent gynecological surgery under general anesthesia were treated with fentanyl intravenous controlled analgesia(PCIA)after operation.After the patient’s venous blood was collected,PCR-RFLP was used to measure the COMT Val158met gene polymorphism in the surgical patients,and the PCIA fentanyl dosage,blood oxygen saturation(SpO 2),Ramasay score and VAS score within 48 hours after operation were recorded and analyzed.Results:The frequencies of AA,GA,and GG genotypes were 19%,47.9%,and 33.1%,respectively;the frequencies of A and G alleles were 29.8%and 70.2%,respectively.There was no significant difference in SpO 2,VAS score and Ramsay score of patients with different genotypes at 6,24,and 48 hours after surgery(all P>0.05).Compared with patients with GG genotype,the fentanyl dosage of patients with AA genotype and GA genotype was significantly reduced at 48 hours after surgery(both P<0.05).Conclusion:There is a significant difference in the analgesic effect of fentanyl among the Han nationality gynecological patients in Yulin area,which may be related to the local COMT Val158met gene polymorphism.

关 键 词：儿茶酚胺氧位甲基转移酶 芬太尼 基因多态性 麻醉 镇痛 妇科 

分 类 号：R614.2[医药卫生—麻醉学]