治疗抵抗精神分裂症患者细胞色素氧化酶基因多态性分析

Analysis of cytochrome oxidase gene polymorphism in patients with treatment-resistant schizophrenia

目的:探索治疗抵抗精神分裂症(TRS)患者抗精神病药代谢基因细胞色素氧化酶(CYP450)多态性。方法:收集80例TRS患者(TRS组)和47例非TRS患者(非TRS组)的临床资料并检测和分析两组患者CYP450同工酶CYP1A2、CYP2C19、CYP2D6及CYP3A4基因型。结果:TRS组CYP450基因表型存在1个以上突变的比例(81.25%)明显高于非TRS组(72.34%)(χ2=26.317,P<0.01);TRS组CYP450基因表型突变集中在CYP2C19(58.75%)和CYP2D6(43.75%),且均以慢代谢型为多,且明显高于非TRS组(P<0.05或P<0.01)。结论:TRS患者CYP450基因表型突变率较高,主要集中在CYP2C19和CYP2D6,且均以慢代谢型最多。

Objective:To explore the polymorphism of antipsychotic drug metabolism gene cytochrome oxidase(CYP450)in patients with treatment-resistant schizophrenia(TRS).Method:The clinical data of 80 TRS patients(TRS group)and 47 non-TRS patients(non-TRS group)were collected.The CYP450 isoenzymes CYP1A2,CYP2C19,CYP2D6 and CYP3A4 genotypes were detected and analyzed in the two groups.Results:In the TRS group,the proportion(81.25%)with more than one mutation in CYP450 gene-phenotype was significantly higher than that in the non-TRS group(72.34%)(χ2=26.317,P<0.01).The CYP450 gene-phenotype mutation in the TRS group was concentrated in CYP2C19(58.75%)and CYP2D6(43.75%),most of which had poor metabolism,and were significantly higher than those in the non-TRS group(P<0.05 or P<0.01).Conclusion:The CYP450 gene-phenotype mutation rate of TRS patients is relatively high,mainly in CYP2C19 and CYP2D6,in which poor metabolism is the most common.