ORM1 A113G基因多态性对女性患者维库溴铵肌松效应的影响

Effect of ORM1 A113G genetic polymorphism on neuromuscular blockade induced with vecuronium in guizhou Han nationality female patient

目的 探讨ORM1 A113G基因多态性对女性患者维库溴铵肌松效应的影响.方法 选择择期全麻下乳腺包块切除术贵州汉族女性患者107例,年龄18～65岁.术前采集外周静脉血5 ml,使用天根血液基因组DNA提取试剂盒抽取DNA.采用3730XLDNA测序仪直接测序对ORM1 A113G进行基因分型.麻醉诱导期间给予维库溴铵0.1 mg/kg,用TOF-Watch加速度仪进行肌松监测.观察起效时间、时效、体内作用时间、恢复指数、TOF恢复到25％的时间.结果 根据基因型将患者分为野生型纯合子组（AA组,n=71）、突变型杂合子组（AG组,n=35）和突变型纯合子组（GG组,n=1）.将AG组和G-G组两种基因型合并为变异组.与AA组比较,变异组的时效和TOF恢复到25％时间均明显延长（P＜0.05）;起效时间、恢复指数和体内作用时间差异无统计学意义.结论 ORM1 A113G基因多态性可在一定程度上影响贵州汉族女性患者维库溴铵的肌松效应.

Objective To discuss the impact of ORM1 All3G genetic polymorphisms on neuro- muscular blockade induced with vecuronium. Methods A total of 107 female patients （age 18-65 years） undergoing breast mass excision surgery were enrolled in this clinical trial between Jan 2013 and Sep 2013. Vecuronium of 2ED95 （0. 1 mg/kg） was injected during anesthesia induction, using TOF-Watch acceleration monitoring instrument for muscle relaxation. Thumb adductorius contractile response was monitored with train of four（TOF） stimulation. The time of neuromuscular block onset, duration of blockade maintenance, duration of in vivo action, recovery index and the time of TOF ration of recovery to 25% were recorded. Genomic DNA was extracted by using TIANamp genomic DNA kit and Sequenced by 3730XL DNA sequencer. Results According to the ORM1 genotypes, 107 patients were divided into two groups： mutational group（AG and GG groups,n=36） and wild group （AA group, n= 71）. Compared with wild group, there were no significant differences of muscle relax- ant onset time, neuromuscular block recover index and duration of action in vivo, however, duration of blockade maintenance and the time of TOF ration of recovery to 25% were longer in mutational group（P〈0.05）. Conclusion ORM1 All3G genetic polymorphism could influence the neuromuscular blockade induced with vecuronium, indicating that the genetic factor is one of the reason contributing to the individual variation in neuromuscular blockade induced with muscle relaxants in guizhou Han nationality female patient.