COMT V158M多态性、疼痛敏感性以及阿片需求量相关性分析  

Influence of COMT V158M polymorphism on pain sensitivity and opioid demand

作　　者：孟雅玲 张斯璧[2] 薛洲亚 MENG Yaling;ZHANG Sibi;XUE Zhouya(Department of Pediatric Cardiothoracic Surgery,Jiangsu Province Hospital,Suqian,Jiangsu 210009,China;Department of Anesthesiology,Jiangsu Province Hospital,Taizhou,Jiangsu 210009,China;Department of Anesthesiology,Yancheng NO.1 People's Hospital,Yancheng,Jiangsu 224006,China)

机构地区：[1]江苏省人民医院小儿心胸外科,江苏宿迁210009 [2]江苏省人民医院麻醉科,江苏泰州210009 [3]盐城市第一人民医院麻醉科,江苏盐城224006

出　　处：《中国优生与遗传杂志》2022年第9期1625-1629,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的 探讨COMT基因V158M多态性、疼痛敏感性以及阿片需求量间的关系。方法 选取2019年1—8月于江苏省人民医院住院治疗并确诊为肺癌的患者220例作为研究对象,其中肺癌伴疼痛者116例;肺癌不伴疼痛者104例。采用PCR-RFLP检测220例肺癌患者COMT基因V158M的基因型。使用多因素Logistic回归分析筛选可能引起肺癌疼痛的影响因素。比较中、重度疼痛组患者不同基因型间48 h阿片类药物用量、状态特质焦虑量表评分和睡眠质量评分。结果 疼痛组与无痛组VV、VM及MM基因型频率分布均符合Hardy-Weinberg遗传平衡定律(P>0.05)。TNM分期(OR=4.559,95%CI:3.169~5.952,P=0.001)、基因型(OR=8.829,95%CI:6.475~9.293,P=0.005)是肺癌疼痛发生的独立危险因素;轻度疼痛组、中度疼痛组和重度疼痛组中,MM基因型分布频率明显升高;以上差异均有统计学意义(P<0.05)。中、重度疼痛组不同基因型病人48 h阿片类药物用量依次明显减少,且MM基因型患者用药量最少。结论 COMT基因V158M多态性可能与疼痛敏感性及阿片类镇痛药用量有关。Objective To explore the influence of COMT V158M polymorphism on pain sensitivity and opioid demand. Methods 220 patients with lung cancer who were hospitalized in Jiangsu Provincial people’s Hospital from January to August 2019 were selected as subjects, including 116 patients with lung cancer with pain and 104 patients with lung cancer without pain. PCR-RFLP was used to detect the genotype of COMT V158M in 220 patients with lung cancer. ANOVA and multivariate logistic regression analysis were used to analyze the factors that may affect the occurrence of lung cancer pain.The 48-hour opioid dosage, sleep quality score and state trait anxiety scale scores of patients with moderate and severe pain were compared between different genotypes. Results The frequency distribution of VV, VM and MM genotypes in pain group and painless group conformed to the law of Hardy-Weinberg genetic equilibrium. TNM staging(OR=4.559, 95%CI:3.169-5.952, P=0.001) and genotype(OR=8.829, 95%CI: 6.475-9.293, P=0.005) were independent risk factors for lung cancer pain, and the frequency of MM genotype increased significantly in mild pain group, moderate pain group and severe pain group. The opioid dosage of patients with different genotypes in moderate and severe pain groups decreased significantly in turn, and the dosage of opioids in patients with MM genotype was the least, and the above differences were statistically significant(P<0.05). Conclusion COMT V158M may be related to pain sensitivity and the dosage of opioid analgesics.

关 键 词：COMT V158M 多态性 疼痛敏感性 阿片需求量 相关性 

分 类 号：R734.2[医药卫生—肿瘤]