氯氮平片治疗精神分裂症疗效与COMT基因多态性关系研究

Relationship between efficacy of clozapine tablets and COMT gene polymorphism in the treatment of schizophrenia

目的研究氯氮平片治疗精神分裂症疗效与儿茶酚-O-甲基转移酶(COMT)基因多态性的关系。方法选取80例精神分裂症患者为观察组,给予氯氮平片药物治疗;选择同期体检健康志愿者80名为对照组。通过聚合酶链式反应-限制性片段长度多态分析(PCR-RFLP)法,对精神分裂症患者开展COMT基因分型;同时选择临床总体印象评定量表(CGI)以及阳性和阴性综合征量表(PANSS)对氯氮平片治疗效果进行评定。结果两组基因型、等位基因频率比较差异均存在统计学意义(P<0.05),其中观察组V/V基因型频率低于对照组(P<0.05),M/M基因型频率高于对照组(P<0.05)。观察组V/V、V/M和M/M基因型的首发年龄、病程比较,差异存在统计学意义(P<0.05)。治疗后,观察组PANSS量表总分及各因子评分以及PANSS 5因子评分、CGI中SI指数均较治疗前降低(P<0.05);EI指数较治疗前提高(P<0.05)。治疗后,V/V、V/M和M/M基因型PANSS总分及各因子分以及CGI中SI指数均较各自治疗前降低(P<0.05),且EI指数均较各自治疗前升高(P<0.05)。治疗前与治疗后,COMT不同基因型间PANSS、CGI量表评分比较差异均无统计学意义(P>0.05)。结论精神分裂症患者COMT基因多态性与健康群体相比有一定特征,氯氮平片能够改善精神分裂症患者的临床症状,但不同COMT基因型精神分裂症患者采用氯氮平药物治疗效果无明显不同。

Objective To explore the relationship between the efficacy of clozapine tablets in the treatment of schizophrenia and Catechol-O-Methyl Transferase(COMT)gene polymorphisms.Methods A total of 80 patients with schizophrenia in observation group treated with clozapine tablets and 80 healthy volunteers in control group were selected.COMT genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism analysis(PCR-RFLP)in both groups;Clinical Global Impressions Scale(CGI)and Positive and Negative Syndrome Scale(PANSS)were assessed in observation group.Results There existed significant differences in the genotype and allele frequencies between two groups(P<0.05).The frequency of V/V in observation group was significantly lower than that in control group(P<0.05),and the frequency of M/M was significantly higher than that in control group(P<0.05).There were significant differences in onset ages and disease courses among V/V,V/M and M/M genotypes in observation group(P<0.05).After treatment,the total score and all factor scores of PANSS,PANSS five factor scores and SI index in CGI decreased significantly compared with those before treatment in observation group(P<0.05),and the EI index in CGI increased significantly(P<0.05).In V/V,V/M and M/M genotypes in observation group,the total scores and all factor scores of PANSS and SI index in CGI after treatment decreased significantly compared with those before treatment(P<0.05),and the EI index in CGI increased significantly(P<0.05).There existed no differences in PANSS and CGI scores among patients with different COMT genotypes both before and after treatment(P>0.05).Conclusion The COMT gene polymorphism in patients with schizophrenia have certain characteristics compared with the healthy population.Clozapine tablets can improve the clinical symptoms in patients with schizophrenia,but there is no significant difference in the efficacy of clozapine treatment in patients with different COMT genotypes.