OPRM1 rs1799971多态性对术中瑞芬太尼剂量影响的基因剂量效应研究

Effect of OPRM1 rs1799971 polymorphism on intraoperative remifentanil dose

  • 摘要:
    目的 探讨壮族人群μ阿片受体基因(OPRM1) rs1799971(A118G)基因多态性对术中瑞芬太尼消耗剂量的影响。
    方法 选取广西壮族接受腹腔镜结直肠癌手术患者212例为研究对象。术后根据OPRM11 A118G基因多态性将患者分为AA组(野生纯合子型)、AG组(杂合子型)和GG组(突变纯合子型)。手术麻醉采用丙泊酚进行镇静诱导与维持,瑞芬太尼根据手术应激反应调整镇痛剂量。监测患者生命体征,记录麻醉时间、手术时间及术中丙泊酚靶控输注(TCI)浓度,统计单位时间内瑞芬太尼用量。
    结果 212例患者OPRM1 A118G基因分型为AA型50.5%、AG型41.0%和GG型8.5%, G等位基因的分布频率为29.0%。AG组、GG组术中瑞芬太尼消耗量与AA组比较,差异有统计学意义(P<0.05); AG组与GG组术中瑞芬太尼消耗量比较,差异有统计学意义(P<0.05)。3组瑞芬太尼消耗量呈现基因剂量效应: GG组(0.59±0.07) μg/(kg·min)>AG组(0.42±0.09) μg/(kg·min)>AA组(0.33±0.07) μg/(kg·min)。OPRM1 A118G基因多态性是术中瑞芬太尼消耗剂量的独立影响因素(P<0.01)。
    结论 广西壮族人群OPRM1 A118G多态性与瑞芬太尼用药剂量相关,携带G等位基因的患者术中瑞芬太尼用量较高。

     

    Abstract:
    Objective To investigate the impact of μ-opioid receptor gene (OPRM1) rs1799971 (A118G) polymorphism in the Zhuang population on the intraoperative remifentanil consumption dose.
    Methods A total of 212 patients of Zhuang population undergoing laparoscopic colorectal cancer surgery in Guangxi were selected as the study subjects. After surgery, the patients were divided into AA group (wild-type homozygous), AG group (heterozygous) and GG group (mutant homozygous) based on OPRM1 A118G gene polymorphism. Propofol was used for sedation induction and maintenance during anesthesia, and the analgesic dose of remifentanil was adjusted according to the surgical stress response. The patients′ vital signs were monitored, and the anesthesia time, surgical time and intraoperative propofol target-controlled infusion (TCI) concentration were recorded. The amount of remifentanil used per unit time was calculated.
    Results The genotyping of OPRM1 A118G in 212 patients was AA type (50.5%), AG type (41.0%) and GG type (8.5%), and the distribution frequency of the G allele was 29.0%. The consumption of remifentanil during the operation in the AG group and GG group showed signtficant difference compared with that in the AA group (P<0.05); there was a statistically significant difference in the intraoperative consumption of remifentanil between the AG group and the GG group (P<0.05). A gene-dose effect was observed in remifentanil consumption among the three groups: the GG group(0.59±0.07) μg/(kg·min) > the AG group (0.42±0.09) μg/(kg·min)>the AA group (0.33±0.07) μg/(kg·min). OPRM1 A118G gene polymorphism was an independent factor influencing intraoperative remifentanil consumption (P<0.01).
    Conclusion OPRM1 A118G polymorphism in the Zhuang population in Guangxi Zhuang autonomous region is associated with the dosage of remifentanil, with patients carrying the G allele requiring higher intraoperative doses of remifentanil.

     

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