亚洲人群OPRM1基因rs1799971多态性和术后阿片类药物使用剂量关系的Meta分析

Association between rs1799971 Polymorphism in OPRM1 Gene on Opioid Requirements after Surgery in Asians:A Meta-analysis

目的系统评价亚洲人群OPRM1基因rs1799971多态性和术后病人阿片类药物使用剂量之间的相关性。方法计算机检索CNKI、CBM、VIP、Wan Fang Data、EMbase和MEDLINE数据库,搜集有关亚洲人群OPRM1基因rs1799971多态性和术后24小时阿片类药物使用剂量相关性的病例-对照研究。检索时限均为从建库至2015年3月1日。由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.2软件进行Meta分析。结果共纳入10个研究,合计1 612例病例。Meta分析结果显示:突变纯合子(GG)术后24小时阿片类镇痛药的需要量较野生杂合子(AG)高[SMD=–0.44,95%CI(–0.61,–0.28),P<0.000 01];突变纯合子(GG)术后24小时阿片类镇痛药的需要量较野生纯合子(AA)高[SMD=–0.55,95%CI(–0.71,–0.38),P<0.000 01]。突变纯合子(GG)术后24小时阿片类镇痛药的需要量较野生型(AA+AG)高[SMD=–0.50,95%CI(–0.66,–0.35),P<0.000 01]。结论当前证据显示,携带OPRM1基因(rs1799971)GG突变的亚洲人群,术后24小时阿片类药物需要量较高。受纳入研究数量和质量的限制,上述结论尚需要更多研究予以证实。

Objective To evaluate the relationship between OPRM1 gene rs1799971 polymorphism and opioid analgesics requirement after surgery in Asians. Methods We electronically searched databases including CNKI, CBM, VIP, WanFang Data, EMbase and MEDLINE to collect studies about the correlation between OPRM1 gene rs1799971 polymorphism and opioid analgesics requirement after surgery in Asia. The retrieval time was from the establishment to March 1st, 2015. Two reviewers independently screened literature, extracted data and assessed the risk bias of including studies, and then meta-analysis was performed by using RevMan 5.2 software. Results A total of 10 case-control studies involving 1 612 patients were included. The results of meta-analysis showed that the requirement of opioid analgesics after surgery for GG genotype carriers was more than AG carriers （SMD=-0.44, 95%CI -0.61 to -0.28, P〈0.000 01）, AA genotype carriers （SMD=-0.55, 95%CI -0.71 to -0.38, P〈0.000 01）, and AA＋AG genotype carriers （SMD = -0.50, 95%CI -0.66 to -0.35, P〈0.000 01）. Conclusion The current evidence showed that the requirement of opioid analgesics after surgery for GG genotype of rs1799971 polymorphism in OPRM1 gene is higher in Asians. Due to the limited quality and quantity of included studies, the above results are needed to be further validated by more studies.