ADRB1基因多态性与结直肠癌患者疼痛敏感度及腹腔镜术后芬太尼镇痛效果的关联

The Correlation of ADRB1 Gene Polymorphism with Pain Sensitivity and Analgesic Effect of Fentanyl after Laparoscopic Resection in Colorectal Cancer Patients

目的探索beta肾上腺素受体1(ADRB1)基因多态性与接受腹腔镜根治术的结直肠癌患者疼痛敏感度及术后芬太尼镇痛效果的关联。方法连续纳入191例将要接受腹腔镜根治术治疗的结直肠癌患者,采用PCR-RFLP检测患者ADRB1 rs1801252 A145G和ADRB1 rs1801253 G1165C的基因多态性。患者入组后,术前进行疼痛敏感评估(PPL),术中记录麻醉指标,术后收集48 h内芬太尼的使用量,评估患者疼痛,并持续随访评估患者的总体生存期。结果191例中,ADRB1 rs1801252 AA,AG,GG携带者人数分别为132例(69.1%),55例(28.8%)及4例(2.1%);ADRB1 rs1801253 CC,CG,GG携带者人数分别为120例(62.8%),59例(30.9%)及12例(6.3%)。ADRB1 rs1801252 AA携带者PPL值最低,AG携带者次之,GG携带者最高。ADRB1 rs1801253基因多态性与患者的PPL无明显关联。结合术后芬太尼的使用以及患者的疼痛评估,ADRB1 rs1801252 AA携带者术后芬太尼镇痛效果最差,AG携带者次之,GG携带者最好。ADRB1 rs1801253基因多态性与术后芬太尼镇痛效果无明显关联。此外,ADRB1 rs1801252和rs1801253基因多态性均与患者的总体生存期无明显关联。结论ADRB1 rs1801252 A145G基因多态性与接受腹腔镜根治术的结直肠癌患者的疼痛敏感度以及术后芬太尼镇痛效果相关,为更好实现个体化疼痛治疗提供了有价值的信息。

Objective To explore the correlation of beta-adrenoceptor-1(ADRB1)gene polymorphism with pain sensitivity and analgesic effect of fentanyl after laparoscopic resection for colorectal cancer patients.Methods A total of 191 colorectal cancer patients who were about to receive laparoscopic resection were consecutively enrolled.ADRB1 rs1801252 A145G and ADRB1 rs1801253 G1165C single nucleotide polymorphism were detected using PCR-RFLP,and latency to pain perception(PPL)was tested in all patients before surgery.The anesthetic indexes during surgery,patients’pain assessment and anesthesia usage within 48 hours after surgery,and overall survival were recorded for analysis.Results Among all the colorectal cancer patients enrolled in this study,the numbers of ADRB1 rs1801252 AA,AG,GG carriers were 132(69.1%),55(28.8%),4(2.1%)respectively,and the numbers of ADRB1 rs1801253 CC,CG,GG carriers were 120(62.8%),59(30.9%),12(6.3%)respectively.ADRB1 rs1801252 AA carriers presented lowest PPL,followed by AG carriers,and GG carriers.Combining the usage of fentanyl and pain assessment,ADRB1 rs1801252 AA carriers presented the poorest analgesia effect,followed by AG carriers,and then GG carriers.As for survival,none of ADRB1 rs1801252 or ADRB1 rs1801253 gene polymorphism was correlated with OS in colorectal cancer patients underwent laparoscopic radical resection.Conclusion ADRB1 rs1801252 A145G polymorphism is correlated with pain sensitively and analgesic effect of fentanyl after laparoscopic resection in colorectal cancer patients,which provides valuable information for better individualized pain management.