肝药酶CYP2C19基因多态性与抗抑郁药所致肝功能改变的关系

Relationship between polymorphism of CYP2C19 gene and changes of liver function induced by antidepressants

目的:探讨肝药酶CYP2C19基因多态性与抗抑郁药所致肝功能改变的关系。方法:检测35例应用抗抑郁药稳定剂量(符合临床诊疗指南推荐剂量)持续2周的患者CYP2C19基因多态性及治疗前后各项肝功能指标,并进行各基因型肝功能指标变化的比较。结果:35例患者中,CYP2C19基因型为快代谢型8例,中代谢型26例,慢代谢型1例。入组者肝功能指标基线均在正常范围;治疗2周后血清碱性磷酸酶(ALP)(P=0. 016)、总蛋白(TP)(P=0. 025)、总胆红素(TBIL)(P=0. 029)、直接胆红素(DBIL)(P=0. 035)水平明显下降;丙氨酸氨基转移酶(ALT)/天冬氨酸氨基转移酶(AST)(P=0. 032)、前白蛋白(PA)(P=0. 16)水平显著升高;各代谢型间治疗前后肝功能各项指标差值比较差异无统计学意义。结论:肝药酶CYP2C19基因多态性可能与抗抑郁药所致肝功能改变无关。

Objective:To investigate the relationship between CYP2C19 gene polymorphism and liver function changes induced by antidepressants.Method:The CYP2C19 gene polymorphism and liver function of 35 patients treated with antidepressants in accordance with the recommended dose of clinical guidelines for 2 weeks were detected.The changes of liver function indexes in patients with different genotypes were compared.Results:In the 35 patients,CYP2C19 genotype were fast metabolic type in 8 cases,moderate metabolic type in 26 cases and slow metabolic type in 1 case.The baseline of liver function indicators for all the patients were in the normal range.After 2 weeks of treatment,serum alkaline phosphatase(ALP)(P=0.016),total Protein(TP)(P=0.025),total bilirubin(TBIL)(P=0.029)),direct bilirubin(DBIL)(P=0.035)were decreased significantly;while the levels of alanine aminotransferase(ALT)/aspartic acid aminotransferase(AST)(P=0.032),pre-albumin(PA)(P=0.16)were significantly increased.There was no significant difference in liver function indexes among different metabolic types after treatment.Conclusion:The CYP2C19 gene polymorphism may not be related to the changes of liver function induced by antidepressants.