ABCB1基因多态性对帕洛诺司琼预防腹部手术患者术后恶心呕吐的影响

Effects of ABCB1 gene polymorphism on palonosetron for the prevention of postoperative nausea and vomiting for patients undergoing abdominal surgery

目的探讨ABCB1基因多态性对帕洛诺司琼(PAL)预防腹部手术术后恶心呕吐(PONV)的影响。方法纳入122例进行腹部手术,于麻醉诱导前给予PAL预防PONV,术后使用氢吗啡酮自控镇痛的患者。对ABCB1基因(rs1002205,rs1045642,rs1128503,rs1202179,rs2032582,rs2235047,rs4728709,rs868755)进行基因分型。结果对于ABCB1 rs868755,携带T基因突变是PONV发生的保护因素(OR=0.14,95.0%CI:0.04~0.47,P<0.001),其余单核苷酸多态性(SNP)与PONV均无相关性。多因素Logistic回归方程纳入了性别、ABCB1 rs868755基因多态性和氢吗啡酮剂量,可以解释本研究人群中42.7%的PONV个体差异。结论ABCB1 rs868755基因多态性是帕洛诺司琼预防PONV的独立预测因素,可以作为优化临床用药方案的参考。

Objective To investigate the influence of genetics polymorphism in ABCB1 on palonosetron(PAL)for the prevention of postoperative nausea and vomiting(PONV)after abdominal surgery.Methods A total of 122 patients undergoing abdominal surgery(who received PAL to prevent PONV and used hydromorphone to controll analgesia after surgery)were included.ABCB1 polymorphism(rs1002205,rs1045642,rs1128503,rs1202179,rs2032582,rs2235047,rs4728709,rs868755)were genotyped.Results For ABCB1 rs868755 on PONV,T allele is a protective factor(OR=0.14,95.0%CI=0.04-0.47,P<0.001).However,no significant relationship was found between other single nucleotide polymorphism(SNP)and PONV(P>0.05).Multivariate Logistic regression analysis indicated that sex and the ABCB1 rs868755 and hydromorphone consumption may account for the interindividual difference of PONV(42.7%).Conclusion ABCB1 rs868755 genetic polymorphism could be the determinants of PONV,which may help to optimize clinical medication.