OPRM1(A118G)基因多态性与阿片类药物镇痛效果的系统性评价  

Systematic evaluation of OPRM1(A118G)gene polymorphisms and analgesic efficacy of opioids

作　　者：VOEURN CHHING 黎慧玲 覃英[2] VOEURN CHHING;LI Hui-ling;QIN Ying(Youjiang Medical University for Nationalities,Baise 533000,Guangxi,CHINA;Department of Anesthesiology,the Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,CHINA)

机构地区：[1]右江民族医学院,广西百色533000 [2]右江民族医学院附属医院麻醉科,广西百色533000

出　　处：《海南医学》2024年第12期1787-1793,共7页Hainan Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20190382);右江民族医学院附属医院高层次人才科研项目(编号:y20196306)。

摘　　要：目的系统评价OPRM1(A118G)基因多态性与阿片类药物镇痛效果之间的关系。方法通过检索自建库至2024年3月中国知网、万方、维普数据库和PubMed、Web of Science、Cochrane Library、Embase数据库的相关临床研究,严格按照纳入和排除标准筛选文献,提取数据后采用Rev-Man 5.4软件进行Meta分析。结果纳入19项研究共3097例患者。Meta分析结果显示:AA型的患者术后24 h的VAS评分与AG型比较差异无统计学意义(SMD=-0.04,95%CI:-0.10~0.03,P=0.26);AA型的患者术后24 h的VAS评分与GG型比较差异无统计学意义(SMD=-0.58,95%CI:-1.29~0.13,P=0.11);AG型的患者术后24 h的VAS评分与GG型比较差异无统计学意义(SMD=-0.59,95%CI:-1.29~0.11,P=0.10)。AA型的患者术后24 h的阿片类药物消耗量与AG型比较差异有统计学意义(SMD=-0.32,95%CI:-0.63~-0.02,P=0.04);AA型的患者术后24 h的阿片类药物消耗量与GG型比较差异有统计学意义(SMD=-1.05,95%CI:-1.66~-0.44,P=0.0007);AG型的患者术后24 h的阿片类药物消耗量与GG型比较差异有统计学意义(SMD=-0.77,95%CI:-1.22~-0.33,P=0.0007)。结论OPRM1(A118G)基因多态性会降低阿片类药物的镇痛效果,其与术后24 h的VAS评分无关,但与术后24 h阿片类药物的消耗量有关,G等位基因携带的患者术后24 h阿片类药物的消耗量更大。Objective To systematically review the association between OPRM1(A118G)gene polymorphisms and the analgesic efficacy of opioids.Methods By searching the relevant clinical studies of CNKI,Wanfang,VIP databases,PubMed,Web of Science,Cochrane Library,and Embase from inception to March 2024,the literature were screened in strict accordance with the inclusion and exclusion criteria.The data were extracted and the Rev-Man 5.4 software was used for meta-analysis.Results Nineteen studies with a total of 3097 patients were included.The results of meta-analysis showed that there was no significant difference in VAS score at 24 hours after operation between patients with AA type and AG type(SMD=-0.04,95%CI:-0.10 to 0.03,P=0.26),between patients with AA type and GG type(SMD=-0.58,95%CI:-1.29 to 0.13,P=0.11),or between patients with AG type and GG type(SMD=-0.59,95%CI:-1.29 to 0.11,P=0.10).There was a statistically significant difference in opioid consumption at 24 hours after surgery between patients with AA type and AG type(SMD=-0.32,95%CI:-0.63 to-0.02,P=0.04),between patients with AA type and GG type(SMD=-1.05,95%CI:-1.66 to-0.44,P=0.0007),and also between patients with AG type and GG type(SMD=-0.77,95%CI:-1.22 to-0.33,P=0.0007).Conclusion The OPRM1(A118G)gene polymorphism can reduce the analgesic effect of opioids,which is not related to the VAS score at 24 h after surgery but is related to the consumption of opioids at 24 h after surgery.Patients with G allele have a greater consumption of opioids at 24 h after surgery.

关 键 词：OPRM1(A118G) 基因多态性 阿片类药物 META分析 

分 类 号：R969[医药卫生—药理学]