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中华危重症医学杂志(电子版) ›› 2018, Vol. 11 ›› Issue (02) : 90 -93. doi: 10.3877/cma.j.issn.1674-6880.2018.02.004

所属专题: 文献

论著

CYP3A4*1G基因多态性对老年患者全髋置换术后舒芬太尼药效学的影响
王琳1, 朱贤平2, 罗宇1, 林学正1,(), 尧章泉1   
  1. 1. 318000 浙江台州,台州市中心医院(台州学院附属医院)麻醉科
    2. 318000 浙江台州,台州市中心医院(台州学院附属医院)骨科
  • 收稿日期:2018-01-23 出版日期:2018-04-01
  • 通信作者: 林学正
  • 基金资助:
    2017年台州市级科技计划B类项目(1702KY19); 2017年台州学院培育项目(2017PY044)

Effects of CYP3A4*1G genetic polymorphism on pharmacokinetics of sufentanil in elder patients undergoing total hip replacement

Lin Wang1, Xianping Zhu2, Yu Luo1, Xuezheng Lin1,(), Zhangquan Yao1   

  1. 1. Department of Anesthesiology, Taizhou Central Hospital (TaiZhou University Hospital), Taizhou 318000, China
    2. Department of Orthopedics, Taizhou Central Hospital (TaiZhou University Hospital), Taizhou 318000, China
  • Received:2018-01-23 Published:2018-04-01
  • Corresponding author: Xuezheng Lin
  • About author:
    Corresponding author: Lin Xuezheng, Email:
引用本文:

王琳, 朱贤平, 罗宇, 林学正, 尧章泉. CYP3A4*1G基因多态性对老年患者全髋置换术后舒芬太尼药效学的影响[J/OL]. 中华危重症医学杂志(电子版), 2018, 11(02): 90-93.

Lin Wang, Xianping Zhu, Yu Luo, Xuezheng Lin, Zhangquan Yao. Effects of CYP3A4*1G genetic polymorphism on pharmacokinetics of sufentanil in elder patients undergoing total hip replacement[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2018, 11(02): 90-93.

目的

探讨CYP3A4*1G基因多态性对老年患者全髋置换术后舒芬太尼药效学的影响。

方法

选择2016年1月至2017年8月台州市中心医院择期行全髋置换手术的老年患者116例,术后患者静脉自控镇痛(PCIA)。采用焦磷酸测序法检测CYP3A4*1G基因多态性,根据基因型将患者分成野生型纯合子(AA)组69例、突变型杂合子(GA)组39例和突变型纯合子(GG)组8例。记录并比较所有患者术后6、12、24、48 h静息状态下的视觉模拟疼痛评分(VAS),术后48 h的舒芬太尼总用量、PCIA次数。

结果

三组患者术后6、12、24、48 h的VAS的比较差异均无统计学意义(F=0.907、0.192、0.757、0.256,P均>0.05)。而达到相同镇痛效果的GG组患者术后48 h舒芬太尼消耗量[(89.8 ± 0.8)、(95.8 ± 0.5)、(96.0 ± 0.4)μg,F=25.113,P<0.001]及PCIA次数[(10.9 ± 2.0)、(17.4 ± 4.5)、(18.3 ± 3.7)次,F=35.227,P<0.001]均显著少于AA组和GA组患者。而GA组和AA组术后48 h舒芬太尼消耗量及PCIA次数比较差异均无统计学意义(P均>0.05)。

结论

结合患者基因型调整舒芬太尼药量可减少老年患者药物使用量。

Objective

To investigate the effects of CYP3A4*1G genetic polymorphism on pharmacokinetics of sufentanil in elder patients undergoing total hip replacement.

Methods

Totally 116 elder patients undergoing total hip replacement in Taizhou Central Hospital from January 2016 to August 2017 were enrolled. Patient controlled intravenous analgesia (PCIA) treatment was given after operation. Genotyping of CYP3A4*1G was carried out by pyrosequencing. The patients were assigned into 3 groups according to CYP3A4*1G genotypes: wild homozygote (the AA group, 69 cases), mutation heterozygote (GA group, 39 cases) and mutation homozygote (GG group, 8 cases). The visual analogue scale (VAS) at 6, 12, 24, 48 h, and sufentanil consumption and PCIA times at 48 h after surgery were recorded and compared.

Results

The VAS scores at 6, 12, 24, 48 h after surgery all showed significant differences among three groups (F=0.907, 0.192, 0.757, 0.256; all P > 0.05). The sufentanil consumption [(89.8 ± 0.8), (95.8 ± 0.5), (96.0 ± 0.4) μg; F=25.113, P<0.001] and PCIA times [(10.9 ± 2.0), (17.4 ± 4.5), (18.3 ± 3.7); F=35.227, P<0.001] at 48 h after surgery in the GG group were much lower than those in the AA and GA groups. However, there were no significant differences in above indicators between AA and GA groups (all P > 0.05).

Conclusion

Adjusting sufentanil doses in combination with patient genotypes can reduce drug usage in elder patients.

表1 不同基因型择期行全髋置换手术患者一般资料的比较(±s
表2 不同基因型择期行全髋置换手术患者术后VAS评分的比较(分,±s
表3 三组择期行全髋置换手术患者术后48 h舒芬太尼用量及PCIA次数比较(±s
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