MDR1 C3435T基因多态性与芬太尼术后镇痛效应的关系

Association between MDR1 C3435T genetic polymorphism and postoperative analgesia of fentanyl

目的探索MDR1C3435T基因多态性与芬太尼术后镇痛效应的关系。方法术后随访患者并记录芬太尼镇痛使用量及不良反应发生情况,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术对129例患者进行基因分型,比较不同基因型间芬太尼镇痛效应的差异。结果 129例患者中CC型51例(39.5%)、CT型57例(44.2%)、TT型21例(16.3%)。CT型、TT型患者24 h芬太尼镇痛使用量显著低于CC型(P<0.05),TT型患者48 h芬太尼镇痛使用量显著低于CC型(P<0.05),CT型与CC型48 h芬太尼镇痛量、不同基因型组间不良反应发生率差异无统计学意义。结论 MDR1C3435T与术后不良反应无相关性,但与芬太尼术后镇痛使用量具有相关性,该基因型可能成为疼痛个体化治疗的参考指标。

AIM To investigative the relationship between MDR1 C3435T genetic pol）anorphism and postoperative analgesia of fentanyl. METIIODS The postoperative analgesic requirement of fentanyl and the adverse drug reactions happened were recorded after operation. Polyrnerase chain reaction-restriction fragment length polymorphism （PCR- RFLP） was used to detect the polymorphism of MDR1 C3435T. The analgesic effect was compared among the several pol）anorphisms of MDR1 C3435T. RESULTS In 129 patients, 51（39.5%）, 57（44.2%） and 21（16.3%） were cartiers of CC, CT and TT types, respectively. The 24 h analgesic requirement of patients with CT and Tr types was remarkably higher than that of patients with CC, and the 48 h analgesic requirement of patients with TT type was remark- ably lower than that of patients with CC. There was no association between the 48 h analgesic requirement of patients with CT and CC, also between MDR1 genetic polyTnorphism and postoperative adverse drug reactions. CONCLUSION MDR 1 C3435T genetic polymorphisms are not associated with postoperative adverse drug reactions, but are associated with the analgesic requirement of fentanyl. It probably becomes an indicator of individual therapy on pain.