CYP2D6*10基因多态性与膝关节置换术中曲马多镇痛效果的关系  

Relationship between CYP2D6*10 gene polymorphism and Analgesic Effect of Tramadol During Knee Arthroplasty

作　　者：王亚萍 梁红 WANG Ya-ping;LIANG Hong(Department of Anesthesiology,Xi'an High Tech Hospital,Xi'an,Shaanxi 710075)

机构地区：[1]西安高新医院麻醉科,陕西西安710075

出　　处：《医学临床研究》2022年第3期408-411,共4页Journal of Clinical Research

摘　　要：【目的】探究细胞色素P4502D6*10(CYP2D6*10)基因多态性与膝关节置换术中曲马多镇痛效果的关系。【方法】选择2016年6月至2021年6月本院收治的初次行全膝关节置换术患者345例,采用聚合酶链反应(PCR)测序技术对CYP2D6*10基因分型。收集患者临床资料,分别测量全膝关节置换术后不同时间点膝关节活动度、视觉模拟疼痛评分(VAS),并记录患者不良反应发生情况以评价曲马多镇痛效果,采用χ^(2)检验或Fisher确切概率法评价CYP2D6*10基因多态性与术中曲马多镇痛效果的关系。【结果】PCR测序显示,CYP2D6*10基因野生型(CC型)83例(24.06%)、杂合突变型(CT型)165例(47.82%)、纯合突变型(TT型)97例(28.12%)。CC型、CT型、TT型患者性别、年龄、身高、BMI、手术时间、曲马多使用量、不良反应情况比较,差异均无统计学意义(P>0.05)。与CC型比较,CT、TT型患者同时间关节活动度依次降低,VAS评分均依次升高,其差异有统计学意义(P<0.05)。【结论】CYP2D6*10基因多态性与膝关节置换术中曲马多镇痛效果密切相关,可能对其临床应用有一定指导意义。【Objective】To investigate the relationship between cytochrome P4502D6*10(CYP2D6*10)gene polymorphism and the analgesic effect of tramadol in knee arthroplasty.【Methods】A total of 345 patients who underwent total knee arthroplasty for the first time in our hospital from June 2016 to June 2021 were selected.CYP2D6*10 genotyping was performed by polymerase chain reaction(PCR)sequencing technology.The clinical data of patients were collected.The knee range of motion and visual analog pain score(VAS)at different time points after total knee arthroplasty were measured,and the adverse reactions were recorded to evaluate the analgesic effect of tramadol.The relationship between CYP2D6*10 gene polymorphism and intraoperative tramadol analgesic effect was evaluated by 2test or Fisher exact probability【Results】PCR sequencing showed that 83 cases(24.06%)of CYP2D6*10 gene wild type(CC type),165 cases(47.82%)of heterozygous mutation(CT type)and 97 cases(28.12%)of homozygous mutation(TT type).There was no significant difference in gender,age,height,BMI,operation time,tramadol use and adverse reactions among CC,CT and TT patients(P>0.05).Compared with CC type,CT and TT type patients had lower joint activity and higher VAS score at the same time,and the difference was statistically significant(P<0.05).【Conclusion】CYP2D6*10 gene polymorphism is closely related to the analgesic effect of tramadol in knee arthroplasty,which may have certain guiding significance for its clinical application.

关 键 词：关节成形术 置换 膝 基因表达 多态现象 遗传 曲马朵/投药和剂量 镇痛 

分 类 号：R684.76[医药卫生—骨科学]