儿茶酚氧位甲基转移酶基因多态性对利培酮治疗女性精神分裂症患者所致高泌乳素血症的影响

The role of COMT polymorphism in risperidone-induced hyperprolactinemia in female schizophrenia patients

目的探讨儿茶酚氧位甲基转移酶(COMT)的基因多态性与利培酮在女性精神分裂症(SCZ)患者中所致的泌乳素升高之间的相关性。方法按照符合美国精神病学会的精神障碍诊断和统计手册第四修订版(DSM-Ⅳ)诊断标准,收集湖北省武汉市武东医院和宁波市康宁医院62例中国汉族女性SCZ患者作为研究对象,对照组选取社区汉族女性健康志愿者,共完成65人。两组民族、性别相同,年龄、文化程度差异无统计学意义。利培酮药物治疗前与治疗8周后分别抽取其外周血液样本,采用微粒酶免疫分析法对用药前后的泌乳素含量进行测定,利用聚合酶链式反应-限制性片段长度多态分析(PCR-RFLP)技术对患者外周血所取提取的基因组DNA进行基因分型。结果 COMT基因Val158/108Met多态性与女性SCZ患者的人口学因素没有明显的关联,入组病例在单药应用利培酮治疗8周后泌乳素水平显著升高(P<0.001)。而Val/Val基因型患者血液中的泌乳素水平的升高幅度明显地低于其他基因型(P=0.003)。结论 COMT基因Val158/108Met多态性有望成为预测利培酮治疗女性SCZ所致高泌乳素血症的潜在生物学标记。

Objective To study the association between COMT polymorphism and the hyperprolactinemia of Risperidone in female schizophrenia patients. Methods A total of 62 Chinese Han schizophrenic patients that examined by trained psychiatrists using the Chinese Classification of Mental Disorders（CCMD-3） criteria were recruited in this retrospective study. A microparticle enzyme immunoassay was used for measuring the serum prolactin levels at the beginning of the study and the time of receiving risperidone treatment on the 8^th week. The polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP） method was used for COMT genotypes determined. Results There was no significant association between the COMT Val158Met polymorphism and demographic characteristics of the patients in this study. The prolactin level increases significantly after risperidone treatment（P〈0.001）. However, the Val/Val genotype of the patients showed the lowest prolactin level in all subjects（P=0.003）. Conclusion The COMT Val158/108Met polymorphism may be a potential biomarker with predictive value in Risperidone-induced hyperprolactinemia in female schizophrenia patients.