CYP2C19基因多态性与艾司西酞普兰临床疗效的关系

Relationship between CYP2C19 gene polymorphism and clinical efficacy of escitalopram

目的探讨CYP2C19基因多态性与艾司西酞普兰治疗抑郁症临床疗效的关系。方法对96例抑郁症患者通过数字荧光分子技术检测基因序列,根据基因型将其分为快代谢型(EM,n=35)、中间代谢型(IM,n=46)、慢代谢型(PM,n=15),给予艾司西酞普兰治疗6周。运用汉密尔顿抑郁量表(HAMD-17)和治疗中需处理的不良反应症状量表(TESS)评定治疗过程中的临床疗效和不良反应。结果共得出5种CYP2C19基因型,3种代谢型。治疗后第1、2、4、6周末,3种不同代谢型患者HAMD评分均较各自治疗前降低(P<0.05)。治疗后第6周末,3组患者HAMD评分比较差异有统计学意义(P<0.05)。3组不同代谢型患者治疗有效率比较差异有统计学意义(P<0.05)。EM组治疗有效率低于IM组与PM组(P<0.05)。3组间总不良反应发生率比较差异有统计学意义(P<0.05)。结论CYP2C19基因多态性影响酶的多态性,进而对艾司西酞普兰治疗抑郁症患者的临床疗效及不良反应产生一定的影响。

Objective To explore the relationship between CYP2C19 gene polymorphism and clinical efficacy of escitalopram in the treatment of depression. Methods A total of 96 patients with depression were selected and detected by digital fluorescent molecular technology. They were divided into EM group(35 cases), IM group(46 cases) and PM group(15 cases) and treated with escitalopram for 6 weeks. All the patients were assessed with Hamilton Depression Scale(HAMD-17) and Treatment Emergent Symptoms Scale(TESS). Results,There were five kinds of CYP2C19 genotypes and three metabolic types. At the end of the 1 st , 2 nd , 4 th and 6 th week after treatment, the total scores of HAMD in three groups decreased significantly compared with those before treatment( P <0.05). At the end of the 6 th week after treatment, there existed significant differences in the total scores of HAMD among three groups( P <0.05). There existed significant differences in the effective rates of treatment among three groups( P <0.05), with effective rate of EM group being lower than that of IM group and PM group( P <0.05). There existed significant differences in the incidence rates of total adverse reactions among three groups( P <0.05).ConclusionCYP2C19 gene polymorphism affects the enzyme polymorphism, and then has certain influence on the clinical efficacy and adverse reactions of escitalopram in the treatment of depression.