CYP3A4*1G基因多态性对下腹部手术患者舒芬太尼镇痛效果的影响#br#

Abstract
Figure/Table
References (0)
Related Citation (11)

Download: PDF (1281 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To investigate the effects of CYP3A4*1G genetic polymorphism on analgesia with sufentanil in lower abdominal surgery. Methods: One hundred and twenty patients with ASA I or II, aged 20-65 years who underwent elective lower abdominal surgery under general anesthesia were recruited into this study. Patient-controlled analgesia (PCA) treatment was given after operation. Genotyping of CYP3A4*1G was carried out by pyrosequencing. The patients were assigned into 3 groups according to their genotypes: group I wild homozygote, group II mutation heterozygote and group III mutation homozygote. MAP and HR were monitored before induction of general anesthesia (T0), after intubation 1 min (T1), at skin incision (T2) and extubation (T3), and at 5 min after extubation (T4). Plasma cortisol (Cor) and angiotension II (Ang-II) were measured as well. PCA sufentanil consumption and adverse effects were recorded during the first 24 h after surgery. Results: ①MAP, HR, Cor and Ang-II at T1, T2 and T3 were lower in group I than those in group II and III (P<0.05). ②No significant differences in the scores of VAS were noted between the three groups (P>0.05). While similar degrees of pain control was achieved, patients in the *1G/*1G group (49.8±10.2) μg consumed significantly less sufentanil than that in either the wild-type group (64.6±10.9) μg or the *1/*1G group (62.5±12.7) μg (P<0.01). But there was no significant difference in this index between group II and III (P>0.05). Conclusion: CYP3A4*1G genetic polymorphism is one of the factors contributing to the individual variation in patient’s response to analgesia with sufentanil.

Key words： CYP3A4*1G gene polymorphism sufentanil analgesic effect

Received: 16 November 2015

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LI Li
	LIN Zheng
	XU Jianwei
	QIAN Xiaoweri
	LI Jun.

URL:

https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2016/V46/I4/258

[1] 王安, 周宏灏. 细胞色素氧化酶CYP3A4基因突变与表型研究进展[J]. 中国临床药理学杂志, 2005, 21(16): 459-462.
[2] HSIEH K P, LIN Y Y, CHENG C L, et a1. Novel mutations of CYP3A4 in Chinese[J]. Drug Metab Dispos, 2001, 29(3): 268-273.
[3] DAI D, TANG J, ROSE R, et a1. Identification of variants of CYP3A4 and characterization of their abilities to metabolize testosterone and chlorpyrifos [J]. J Pharmacol Exp Ther, 2001, 299(3): 825-831.
[4] FUKUSHIMA-UESAKA H, SAITO Y, WATANABE H, et a1. Haplotypes of CYP3A4 and their close linkage with CYP3A5 haplotypes in a Japanese population[J]. Hum Mutat 2004, 23(1): 100.
[5] DU J, XING Q, XU L, et a1. Systematic screening for polymorphisms in the CYP3A4 gene in Chinese population[J]. Pharmaeogenomics, 2006, 7(6): 831-841.
[6] DU J,YU L,WANG L, et a1. Differences in CYP3A4*1G genotype distribution and haplotypes of CYP3A4, CYP3A5 and CYP3A7 in 3 Chinese populations[J]. Clin Chim Acta, 2007, 383(1-2): 172-174.
[7] OKUBO M, MURAYAMA N, SHIMIZU M, et a1. CYP3A4 intron 6 C >T polymorphism (CYP3A4*22) is associated with reduced CYP3A4 protein level and function in human liver microsomes[J]. J Toxicol Sci, 2013, 38(3): 349-354.
[8] 程立. 病理生理学进展(四)[M]. 1版. 北京: 北京人民出版社, 1989: 143.
[9] EVANS J M, BITHELL J F, VLACHONIKOLIS I G. Relationship between lower oesophageal contractility, clinical signs and halothane concentration during general anaesthe sia and surgery in man[J]. Br J Anaesth, 1987, 59(11): 1346-1355.
[10] HEYN J, LADURNER R, OZIMEK A, et a1. Diagnosis and preoperative management of multiple injured patients with explorative laparotomy because of blunt abdominal trauma [J]. Eur J Med Res, 2008, 13(11): 517-524.
[11] 蔡宏达, 林财珠. 血管紧张素II与麻醉[J]. 国外医学: 麻醉学与复苏分册, 2004, 255(5): 270-272.
[12] BENEDETTO U, SCIARRETTA S, ROSCITANO A, et a1.Preoperative Angiotensin-converting enzyme inhibitors and acute kidney injury after coronary artery bypass grafting[J] Ann Thorac Surg, 2008, 86(4): l160-l165.
[13] 王永铭, 苏定冯. 药理学进展[M]. 1版. 北京: 科学出版社, 2000: 19.
[14] ZHU B, LIU Z Q, CHEN G L, et a1. The distribution and gender difference of CYP3A activity in Chinese subjects[J]. Br J Clin Pharmacol, 2003, 55(3): 264-269.
[15] EVANS W E, RELLING M V. Moving towards individualized medicine with pharmacogenomics[J]. Nature, 2004, 429(990): 464-468.
[16] ZHANG W, YUAN J J, KAN Q C, et a1. Influence of CYP3A5*3 polymorphism and interaction between CYP3A5*3 and CYP3A4*1G polymorphisms on post-operative fentanyl analgesia in Chinese patients undergoing gynaecological surgery[J]. Eur J Anaesthesiol, 2011, 28(4): 245-250.
[17] 张卫, 张豪勇, 阚全程, 等. CYP3A4*1G基因多态性对女性健康志愿者芬太尼药效学的影响[J]. 中华麻醉学杂志,2012, 32(1): 67-69.
[18] ZHOU Q, YU X, SHU C, et al. Analysis of CYP3A4 genetic polymorphisms in Han Chinese[J]. J Hum Genet, 2011, 56(6): 415-422.
[19] DONG Z L, LI H, CHEN Q X, et a1. Effect of CYP3A4*1G on the fentanyl consumption for intravenous patient-controlled analgesia after total abdominal hysterectomy in Chinese Han population[J]. J Clin Pharm Ther, 2012, 37(2): 153-156.
[20] VAN DER Weide K, VAN DER Weide J. The influence of the CYP3A4*22 polymorphism on serum concentration of quetiapine in psychiatric patients[J]. J Clin Psychopharmacol, 2014, 34(2): 256-260.
[21] TAKANO M, OHYA S, YASUDA K, et a1. Synthesis and biological activity of lα, 2α, 25-trihydroxyvitamin D3: active metabolite of 2α-(3-hydroxypropoxy)-lα, 25-dihydroxyvitamin D3 by human CYP3A4[J]. Chem Pharm Bull (Tokyo), 2014, 62(2): 182-184.