OPRM1 A118G和OPRM1 IVS2+G691C基因多态性对地佐辛及芬太尼术后镇痛效果的影响

Effect of OPRM1 A118G and OPRM1 IVS2+G691C gene polymorphism on fentanyl and dezocine analgesic effect

目的考察OPRM1 A118G和OPRM1 IVS2+G691C基因多态性对地佐辛及芬太尼术后镇痛效果及不良反应的影响。方法选取2018年5-12月行择期全身麻醉开腹手术的腹部恶性肿瘤患者209例,随机分为地佐辛组(n=105)和芬太尼组(n=104)。所有患者均进行基因检测,并记录术后0、6、24、48、72 h的视觉疼痛模拟法(VAS)评分,以及恶心、呕吐等不良反应的发生情况。分别比较基因型对各组患者术后镇痛疗效及不良反应发生情况的影响。结果OPRM1 A118G和OPRM1IVS2+G691C基因多态性对地佐辛组各时间点VAS评分影响不显著;芬太尼组OPRM1 A118G各基因型患者间0 h VAS评分差异存在统计学意义(P=0.033),而其他时间点各基因型VAS评分差异无统计学意义。OPRM1 IVS2+G691C对各时间点VAS评分无显著影响。地佐辛组和芬太尼组患者OPRM1 A118G、OPRM1 IVS2+G691C各基因型不良反应发生情况差异无统计学意义。结论OPRM1 A118G基因多态性对芬太尼术后镇痛效果有影响,对地佐辛术后镇痛效果无影响;OPRM1 IVS2+G691C对两药镇痛效果均无影响;上述基因对术后恶心、呕吐发生情况无影响。

AIM To investigate the effect of OPRM1 A118G,OPRM1 IVS2+G691C gene polymorphism on postoperative analgesia and adverse drug reactions(ADRs).METHODS From May 2018 to December 2018,209 patients of abdominal malignant tumor and for elective surgery under general anesthesia were recruited.The patients were randomly divided into 2 groups:dezocine group(105 patients)and fentanyl group(104 patients),respectively.All patients were tested for genotype,and visual analogue scale(VAS)scores at 0,6,24,48 and 72 h after operation were recorded.The occurrence of ADRs such as nausea and vomiting were recorded.The effects of genotype on the postoperative analgesia effect and ADRs were compared.RESULTS The influence of genotype on the analgesic effect of the 2 groups:the polymorphism of OPRM1 A118G and OPRM1 IVS2+G691C gene had no significant effect on the VAS scores of each time point in the dizocine group;the VAS scores of each genotype in the fentanyl group at 0 h was statistically different(P=0.033),but the VAS scores of each genotype at other time points had no statistical difference.OPRM1 IVS2+G691C had no significant effect on VAS scores at each time point.Comparison of postoperative ADRs of patients with different genotypes between 2 groups:there was no significant difference in incidences of ADRs among the different genotype groups in the dezocine group and fentanyl group.CONCLUSION It is found that the polymorphism of OPRM1 A118G gene has an effect on the postoperative analgesia of fentanyl,no effect on the postoperative analgesia of dizocine,no effect on the analgesic effect of OPRM1 IVS2+G691C,and no effect on the occurrence of postoperative nausea and vomiting was found.