MDR1基因多态性对利培酮治疗首发未服药精神分裂的临床疗效及对认知功能的影响

Effect of MDR1 gene polymorphism on clinical efficacy and cognitive function of risperidone in treatment of patients with first-episode schizophrenia

目的 研究MDR1基因多态性对利培酮治疗首发未服药精神分裂的临床疗效及对认知功能的影响。方法 选择2017年8月至2018年6月在本院住院接受精神分裂治疗患者75例作为观察组,对患者治疗前后的认知功能及基因分型进行分析。结果 MDR1基因型分布频率的实际值与理论值的符合度较好,其分布频率与Hardy-weinberg平衡一致;治疗后,PANSS量表、瞬间记忆测评、数字划消一测验、数字划消二测验、瑞文标准推理测试得分分别为(45.89±3.98)分、(6.42±0.22)分、(40.98±4.89)分、(39.09±4.09)分、(19.08±2.98)分、(40.98±6.98)分,均优于治疗前,差异均有统计学意义(均P<0.05);C1236T的CT和TT型患者利培酮的CD值比CC型患者高,差异有统计学意义(P<0.05);G2677T的TT型患者的利培酮和总活性物的CD值比GG型患者高,差异有统计学意义(P<0.05);而其他基因型患者待测物的各CD值之间比较,差异均无统计学意义(均P>0.05)。结论 MDR1基因是可能影响利培酮的血药浓度,进而对临床疗效及认知功能产生影响。

Objective To study the effect of MDR1 gene polymorphism on the clinical efficacy and cognitive function of risperidone in the treatment of patients first-episode schizophrenia. Methods A total of seventy-five schizophrenic patients hospitalized in our hospital from August, 2017 to June, 2018 were selected as an observation group. The cognitive function and genotype of the patients before and after the treatment were analyzed. Results The actual distribution frequency of MDR1 genotype was in good agreement with the theoretical value, and its distribution frequency was in accordance with Hardy-Weinberg equilibrium. After the treatment, the patients were compared with their respective scales. After the treatment, the scores of PANSS, immediate memory, number deletion test 1 and 2, and Raven's Standard Progressive Matrices were (45.89±3.98),(6.42±0.22),(40.98±4.89)(39.09±4.09),(19.08±2.98), and (40.98±6.98);which were better than those before the treatment (all P < 0.05). The CD values risperidone in the C1236T patients of CT and TT types were higher than that in the patients of CC type (P < 0.05). The CD values of risperidone and total active substances in the G2677T patients of TT type were higher than those in the patients of GG type (P < 0.05). There were no statistical differences in the CD values of the tested substances between the patients with other genotypes (P > 0.05). Conclusion MDR1 gene may affect risperidone concentration in plasma, clinical efficacy, and cognitive function.