DRD2基因多态性与奥氮平治疗早发精神分裂症疗效的相关性研究

Correlation analysis of DRD2 gene polymorphism and the curative effect of olanzapine on early-onset schizophrenia

目的分析多巴胺受体D_(2)(DRD2)基因多态性与奥氮平治疗早发精神分裂症(EOS)疗效的关系。方法选取接受奥氮平单药治疗的214例EOS患者,治疗前采用限制性片段长度多态性(PCR-RFLP)法测定DRD2(rs6276)基因型,并于治疗前及治疗后第8周末进行阳性与阴性症状量表(PANSS)评分,评定疗效;比较不同DRD2(rs6276)基因多态性患者治疗前后PANSS评分、疗效、不良反应发生率。结果治疗后患者PANSS总分及阳性症状、阴性症状、一般精神病理评分均较治疗前下降(P<0.05)。治疗总有效率63.08%,按奥氮平治疗疗效分组,两组DRD2基因rs6276位点等位基因频率符合Hardy-Weinberg平衡定律(P>0.05),有效组中DRD2基因rs6276位点TT基因型、T等位基因频率高于无效组(P<0.05)。不同DRD2(rs6276)基因多态性患者不良反应发生率比较差异均无统计学意义(P>0.05)。回归分析结果显示,DRD2(rs6276)基因型、DRD2(rs6276)等位基因是奥氮平疗效的影响因素(P<0.05)。结论EOS患者中携带DRD2(rs6276)T等位基因、TT基因型患者奥氮平治疗效果更佳,且DRD2(rs6276)基因多态性与不良反应无明显关联。

Objective To explore the relationship between dopamine receptor D_(2)(DRD2)gene polymorphism and the curative effect of olanzapine on early-onset schizophrenia(EOS).Methods A total of 214 patients with EOS treated with olanzapine monotherapy were selected and their DRD2(rs6276)genotypes were detected by PCR-RFLP before treatment.Positive and Negative Syndrome Scale(PANSS)was used to evaluate the curative effect before treatment and after 8 weeks of treatment.PANSS scores,curative effects and incidence rates of adverse reactions were compared among patients with different DRD2(rs6276)gene polymorphisms.Results After treatment,the total score and all factor scores of PANSS in patients were significantly reduced(P<0.05).The total response rate was 63.08%.The patients were grouped according to the curative effect of olanzapine,and the allele frequencies at DRD2 gene rs6276 in two groups conformed to Hardy-Weinberg Law(P>0.05).The proportions of patients carrying T allele and TT genotype in effective group were significantly higher than those in ineffective group(P<0.05).There was no significant difference in the incidence rates of adverse reactions among patients with different DRD2(rs6276)gene polymorphisms(P>0.05).Logistic regression analysis showed that DRD2(rs6276)genotypes and DRD2(rs6276)alleles were factors influencing the curative effect of olanzapine(P<0.05).Conclusion The curative effect of olanzapine is more significant in EOS patients with DRD2(rs6276)T allele and TT genotype.There is no significant correlation between DRD2(rs6276)gene polymorphism and adverse reactions.