HTR3B基因多态性与舒芬太尼引起的恶心和呕吐的相关性研究

Correlation between HTR3B gene polymorphism and sufentanil induced nausea and vomiting

目的探讨HTR3B基因多态性及临床指标对舒芬太尼引起恶心呕吐的影响。方法纳入100例进行腹部手术且术后使用舒芬太尼自控镇痛的患者。对HTR3B基因(rs1176744、rs3782025和rs1672717)进行基因分型、并结合年龄、性别、吸烟习惯等临床资料,分析各种因素对患者出现阿片类药物引起的恶心和呕吐(OINV)的影响。结果本研究中,27例患者出现OINV。对于HTR3B rs1176744,携带A/A纯合子是OINV发生的危险因素(OR=1,P=0.032,占OINV患者88.9%),其余单核苷酸多态性(SNPs)与OINV均无相关性。多因素Logistic回归方程纳入了年龄层、HTR3B rs1176744基因多态性和舒芬太尼剂量,可以解释本研究人群中21.5%的OINV个体差异。结论 HTR3B rs1176744基因多态性是舒芬太尼引起恶心呕吐的独立预测因素,有望成为改善临床用药方案的依据。

Objective To investigate the effect of HTR3B genetic polymorphism and clinical indicators on sufentanil induced nausea and vomiting.Method A total of 100 patients who underwent abdominal surgery follow by sufentanil patient controlled intravenous analgesia were included.The HTR3B gene(rs1176744,rs3782025 and rs1672717)was genotyped,and the influence of various factors on the occurrence of opioid-induced nausea and vomiting(OINV)in patients was analyzed combined with the clinical data such as age,sex and smoking habit.Results In this study,OINV occurred in 27 cases of patients.For HTR3B rs1176744,carrying A/A homozygote is a risk factor for OINV(OR=1,P=0.032,accounting for 88.9%of patients with OINV),and other single nucleotide polymorphisms(SNPs)were not correlated with OINV.Multivariate Logistic regression analysis indicated that sex and HTR3B rs1176744 and sufentanl consumption may account for 21.5%interindividual difference of OINV in the study population.Conclusion The polymorphism of HTR3B rs1176744 can be a determinant for OINV and may be a basis for improving clinical medication regimen.