多药耐药性基因1(MDR1)基因多态性对丙戊酸钠治疗老年癫痫血药浓度的影响  

Effects of gene polymorphism of multidrug resistance gene 1(MDR1)on blood concentration in elderly epilepsy patients treated with sodium valproate

作　　者：董艳[1] 孙田田 宋培光[1] Dong Yan;Sun Tiantian;Song Peiguang(Department of Pharmacy,Huaibei Miners General Hospital,Huaibei,Anhui,235000,P.R.China;Department of Neurology,Huaibei Miners General Hospital,Huaibei,Anhui,235000,P.R.China)

机构地区：[1]淮北矿工总医院药学部,安徽淮北235000 [2]淮北矿工总医院神经内科,安徽淮北235000

出　　处：《老年医学与保健》2023年第3期534-537,542,共5页Geriatrics & Health Care

摘　　要：目的探讨多药耐药性基因1(multidrug resistance 1 gene,MDR1)基因多态性对丙戊酸钠治疗老年癫痫血药浓度的影响。方法选择2021年10月1日—2022年10月1日于淮北矿工总医院诊治的老年癫痫患者86例为研究对象,采用多聚酶连锁反应限制性片段长度多态性(Polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)和测序技术确定MDR1 C3435T位点基因型分布情况,采用柱前衍生化法(HPLC法)测定丙戊酸血清药物浓度,分析MDR1 C3435T基因多态性与丙戊酸钠治疗老年癫痫血药浓度的相关性。结果不同MDR1 C3435T基因型患者丙戊酸钠血药浓度差异有统计学意义(P<0.05)。与CC基因型组比较,TT基因型组和CT基因型组的丙戊酸钠血药浓度均显著升高(P<0.05)。老年癫痫患者使用丙戊酸钠后,突变组胃肠道反应、嗜睡、肝功能异常、肾功能异常等总不良反应发生率显著高于CC基因型组(P<0.05)。结论MDR1 C3435T的TT基因型组和CT基因型组均可增加老年癫痫患者丙戊酸钠的血药浓度,但同时不良反应发生率更高。Objective To investigate the effects of gene polymorphism of multidrug resistance gene 1(MDR1)on blood concentration in elderly epilepsy patients treated with sodium valproate.Methods 86 elderly epilepsy patients diagnosed and treated in Huaibei Miners General Hospital from October 1,2021 to October 1,2022 were selected as the study subjects.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)and sequencing techniques were used to determine the genotype distribution of MDR1 C3435 T locus.The blood concentration of sodium valproate was determined by pre-column derivatization(HPLC).The correlation between MDR1 C3435 T gene polymorphism and the blood concentration of sodium valproate in elderly epilepsy patients was analyzed.Results There was significant difference in blood concentration of sodium valproate in patients with different MDR1 C3435 T genotypes(P<0.05).Compared with the CC genotype group,the blood concentration of sodium valproate in the TT genotype group and CT genotype group was significantly higher(P<0.05).After the use of sodium valproate in elderly epilepsy patients,the total incidence of gastrointestinal reactions,lethargy,liver dysfunction,renal dysfunction and other adverse reactions in the mutation group was significantly higher than that in the CC genotype group(P<0.05).Conclusion Both TT genotype and CT genotype of MDR1 C3435 T can increase the blood concentration of sodium valproate in elderly epilepsy patients,but the incidence of adverse reactions is higher.

关 键 词：老年 癫痫 MDR1基因多态性 丙戊酸钠 血药浓度 

分 类 号：R742.1[医药卫生—神经病学与精神病学]