多巴胺D_3受体Ser9Gly多态性与利培酮治疗首发精神分裂症患者疗效关系

Relationship of efficacy of dopamine D_3 receptor Ser9Gly polymorphism and risperidone in the treatment of first episode schizophrenia patients

目的探讨多巴胺D3受体基因多态性与首发精神分裂症患者精神症状严重度和抗精神病药疗效是否相关。方法对201例首发精神分裂症患者进行利培酮治疗[3～5 mg/d,平均(3.2±1.3)mg/d],疗程8周。采用聚合酶链反应限制性片段长度多态性技术检测多巴胺D3受体基因Ser9Gly多态性。并用阳性和阴性症状量表(PANSS)评定患者治疗前和治疗第8周末的精神症状,分析基因型及其他临床指标与PANSS分值和减分率的关系。结果多巴胺D3受体基因Ser9Gly基因型在各患者组分布频率均符合H-W平衡定律(P>0.05);基因型在治疗显效和未显效组分布频率的差异无统计学意义(χ2=1.995,P=0.369);各基因型亚组临床指标的差异均无统计学意义(均P>0.05);基因型与患者治疗前PANSS总分(χ2=6.605,P=0.018)、治疗第8周末PANSS总减分率(χ2=6.471,P=0.021)和阳性症状减分率(χ2=6.239,P=0.023)均有统计学意义。结论多巴胺D3受体基因Ser9Gly功能多态性可能影响首发精神分裂症患者对利培酮的治疗效应。

Objective To explore the relationship of efficacy of dopamine D3 receptor Ser9Gly polymorphism and risperidone in the treatment of first episode schizophrenia patients.Methods 201 cases of first episode schizophrenia patients were received risperidone treatment [3-5 mg/d,average（3.2±1.3） mg/d],for 8 weeks.The Ser9Gly dopamine D3 receptor gene polymorphism of 201 patients was detected by polymerase chain reaction-restriction fragment length polymorphism.And the psychiatric symptoms of patients before treatment and the treatment of the 8th week was assessed by PANSS.The relationship of genotype and other clinical indicators and PANSS score and reduced rate was analyzed by us.Results Dopamine D3 receptor gene Ser9Gly genotype distribution frequency in each patient group were in line with the HW equilibrium（P 0.05）;genotype in the treatment of cured and not cured groups of the frequency difference not statistically significant（χ2 = 1.995,P = 0.369）;clinical indicators of each genotype subgroup difference were not statistically significant（P 0.05）;genotype with patients before treatment,PANSS total scores（χ2 = 6.605,P = 0.018）,PANSS total reduction in treatment at week 8 pointsrate（χ2 = 6.471,P = 0.021） and positive symptom reduction rate（χ2 = 6.239,P = 0.023） were significantly statistically significant.Conclusion Functional polymorphism of the dopamine D3 receptor gene Ser9Gly may affect the first episode schizophrenia treatment effect of risperidone.