DRD3基因多态性、术前焦虑与汉族术后疼痛患者阿片需求量的相关性研究

Correlation between DRD3 Polymorphisms,Preoperative Anxiety and Postoperative Opioids Requirements in Chinese Han Population Postoperative Pain Patients

目的探讨多巴胺受体D3基因(DRD3)Ser9Gly多态性、术前焦虑及汉族术后疼痛患者阿片需求量三者之间的相关性。方法选择实施择期上腹部手术的汉族患者150例,术前1天对患者进行STAI评估,抽取患者外周静脉血通过聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测DRD3基因多态性,术后记录患者阿片药物镇痛使用量及不良反应发生率。结果150例患者中,Ser/Ser、Ser/Gly、Gly/Gly基因型患者分布频率分别为39.3%、48.7%、12.0%,Ser、Gly等位基因的分布频率分别为63.7%、36.3%;Ser/Gly、Gly/Gly型患者24h和48h阿片药物使用量均显著低于Ser/Ser型(P<0.05),Ser/Ser、Ser/Gly和Gly/Gly不同基因型术前焦虑水平及术后不良反应发生率差异无统计学意义(P>0.05)。术前不同焦虑水平的患者术后24h阿片药物的用量不同(P<0.05)。结论不同术前焦虑水平的患者术后所需阿片药物剂量不同,DRD3 Ser9Gly基因型与术前焦虑水平及术后不良反应无相关性,但可影响我国汉族术后疼痛患者阿片药物需求量,该基因多态性可成为阿片类药物使用剂量的参考指标。

Objective To investigate the association between DRD3 polymorphisms,preoperative anxiety and postoperative opioids requirements in Chinese Han population postoperative pain patients.Methods Totally 150 Chinese Han population patients scheduled to undergo upper abdominal surgery completed the STAI.The DRD3 gene polymorphism was detected by collecting venous blood and polymerase chain reaction with restriction fragment length polymorphism(PCR-RFLP).The postoperative analgesic requirement of opioids and the adverse reaction were recorded after operation.Results Among 150 patients,distribution frequency of Ser/Ser,Ser/Gly and Gly/Gly genotype were 39.3%,48.7%and 12.0%,respectively.Those of Ser and Gly allele were 63.7%and 36.3%.The 24h and 48h analgesic requirement of patients with Ser/Gly and Gly/Gly types was remarkably lower than that of patients with Ser/Ser(P<0.05).There was no association between DRD3 genetic polymorphism and different anxiety levels of patients or postoperative adverse reaction(P>0.05).For patients with different anxiety levels,the mean postoperative opoids doses were significantly different(P<0.05).Conclusion Patients with different preoperative anxiety levels need different postoperative dosage of opioids.DRD3 genotype can influence the dosage of opioids in Chinese Han Population postoperative pain patients,and gene polymorphism can be used as an indicator for dosage of opioids.