新疆维吾尔族、哈萨克族和汉族疼痛敏感性与SLC6A4基因多态性的相关性研究

The relationship between the pain sensitivity of Uygur,Kazak and Han nationality in Xinjiang and the polymorphism of SLC6A4 gene

目的探讨新疆地区维吾尔族、哈萨克族和汉族疼痛敏感性与SLC6A4基因多态性间的相关性。方法随机选取2017年6月至2018年2月在新疆医科大学附属中医医院就诊接受结直肠癌根治术的维吾尔族、哈萨克族、汉族患者各50例,分别采集患者入院后空腹静脉血抽提DNA通过聚合酶链反应-限制性片段长度多态性检测技术(PCR-RFLP)对SLC6A4基因多态性位点进行检测;利用便携式压力测试仪对患者试验性疼痛压力痛阈(PPT)和耐痛阈(PTO)进行检测;术后6、12、24、48h记录患者VAS评分并统计48h内镇痛不全及不良反应发生率。结果维吾尔族高表达5-HTT基因型(18%)、中表达5-HTT基因型(70%)与低表达5-HTT基因型(12%)患者比例与哈萨克族(12%、60%、28%)、汉族(8%、58%、34%)患者差异有统计学意义(χ^2=4.391,P=0.043);3组患者PPT差异无统计学意义(F=0.317,P=0.633),维吾尔族患者PTO低于哈萨克族和汉族患者,差异有统计学意义(F=2.514,P=0.047),同组患者低表达5-HTT基因型患者具有较高的PPT与PTO;术后6hVAS评分显示维吾尔族患者术后痛感高于哈萨克族和汉族患者,差异有统计学意义(F=2.270,P=0.015),同组内VAS评分显示低表达5-HTT基因型的患者在术后6、12、24、48hVAS评分均低于同组其他基因型患者,差异有统计学意义(P<0.05);3组患者术后48h不良反应发生率差异无统计学意义(χ^2=0.862,P=0.298)。结论SLC6A4基因多态性与新疆地区维吾尔族、哈萨克族和汉族疼痛敏感性相关,低表达5-HTT的基因型可提高患者疼痛耐受。

Objective To investigate the relationship between the pain sensitivity of Uygur,Kazak and Han nationality in Xinjiang and the polymorphism of SLC6A4 gene. Methods From June 2017 to February 2018,patients of Uygur,Kazakh and Han nationality (50 cases in each group) in Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University who received the colorectal cancer radical surgery were randomly selected as the research object.DNA was extracted from patients′ fasting venous blood after admission.Polymorphic loci of SLC6A4 gene were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The pressure pain threshold (PPT) and the pain tolerance domain (PTO) were detected by stress stimulation in patients with experimental pain.The VAS scoring system was used to record the postoperative scores of the patients in 6,12,24 and 48 h,and the rate of incomplete analgesia and the incidence of adverse reactions in patients within 48 h was also recorded. Results The proportion of Uygur patients with high expression 5 HTT genotype (18%),moderate expression 5 HTT genotype (70%) and low expression 5 HTT genotype (12%) was significantly different from Kazakh patients (12%,60%,28%) and Han patients (8%,58%,34%)(χ 2=4.391, P=0.043).There was no significant difference in PPT among three groups (F=0.317, P=0.633).The PTO of Uygur patients were lower than that of Kazak and Han patients (F=2.514, P=0.047),and in each group,the patients with low expression of 5-HTT had higher PPT and PTO levels.The VAS scores of the Uygur patients in 6 h after operation were higher than those of the Kazakh and Han patients (F=2.270, P=0.015),and the VAS scores of patients with low expression of 5-HTT were significant lower than other genotypes in each group,and the differences were statistically significant (P<0.05).However,there was no significant difference in the incidence of adverse reactions among the 3 groups (χ 2=0.862, P=0.298). Conclusion SLC6A4 gene polymorphism is associated with pain sensitivity of Uygur,Kazak and Han nationality,and the reduced expression of 5-HTT may improve patients pain tolerance.