摘要
目的研究OPRM1 A118G基因多态性对创伤患者疼痛治疗效果的影响。方法选取2016年9月至2018年9月泸州市人民医院收治的200例创伤患者为研究对象,采用聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)技术检测OPRM1 A118G位点的基因多态性。根据OPRM1 A118G基因多态性将入选患者分为AA组(74例,AA型)、AG组(104例,AG型)和GG组(22例,GG型),比较三组患者行为疼痛评估量表(behavioral pain scale,BPS)评分和血清前列腺素E2(prostaglandin E2,PGE2)、P物质(substance P,SP)、皮质醇、白介素-6(interleukin-6,IL-6)水平及阿片类药物用量、不良反应发生率。结果200例创伤患者中,74例为AA型(37.00%),104例为AG型(52.00%),22例为GG型(11.00%),等位基因A分布频率为63.00%,等位基因G分布频率为37.00%。AA组与AG组患者BPS评分和血清PGE2、SP、IL-6、皮质醇水平比较差异均无统计学意义(均P>0.05),GG组患者上述指标水平均显著高于AA组和AG组(均P<0.05)。AA组患者阿片类药物用量为(22.08±8.34)mg,AG组为(41.22±12.31)mg,GG组为(80.11±31.25)mg,组间比较差异均具有统计学意义(均P<0.05)。阿片类药物镇痛治疗后,AA组与AG组患者不良反应发生率比较差异无统计学意义(P>0.05),GG组患者不良反应发生率显著高于AA组和AG组(均P<0.05)。结论创伤患者OPRM1 A118G基因多态性可明显影响阿片类药物的镇痛效果,等位基因G高表达患者疼痛程度较重,需使用大剂量镇痛药物且不良反应发生率较高。
Objective To study the effect of OPRM1 A118G gene polymorphism on pain treatment in patients with trauma.Method Two hundred trauma patients treated in Luzhou People's Hospital from September 2016 to September 2018 were selected as subjects,polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)technique was used to detect the gene polymorphism of OPRM1 A118G locus,the patients were divided into AA group(n=74,AA type),AG group(n=104,AG type)and GG group(n=22,GG type)according to the OPRM1 A118G gene polymorphism.The behavioral pain scale(BPS)score,serum levels of prostaglandin E2(PGE2),substance P(SP),cortisol and interleukin-6(IL-6),analgesic dosage and incidence of adverse reaction were compared among the three groups.Result Among the 200 trauma patients,74 cases(37.00%)were AA type,104 cases(52.00%)were AG type,and 22 cases(11.00%)were GG type.The distribution frequency of allele A and allele G were 63.00%and 37.00%,respectively.There were no significant differences in BPS scores and serum levels of PGE2,SP,IL-6 and cortisol between AA group and AG group(all P>0.05).The levels of above indexes in GG group were significantly higher than those in AA group and AG group(all P<0.05).The dosage of opioids in AA group was(22.08±8.34)mg,AG group was(41.22±12.31)mg,GG group was(80.11±31.25)mg,there was significant difference among the three groups(all P<0.05).After opioid analgesia,there was no significant difference in the incidence of adverse reactions between AA group and AG group(P>0.05).The incidence of adverse reactions in GG group was significantly higher than that in AA group and AG group(all P<0.05).Conclusion OPRM1 A118G gene polymorphism in trauma patients can significantly affect the analgesic effect of opioids.The degree of pain is severe of patients with high expression of allele G,they need to use high-dose analgesics and have a higher incidence of adverse reactions.
作者
谭灵
黄学平
付禹尧
吴文友
Tan Ling;Huang Xueping;Fu Yuyao;Wu Wenyou(Department of Neurosurgery,Luzhou People's Hospital,Sichuan,Luzhou 646000,China)
出处
《中国医学前沿杂志（电子版）》
2020年第12期72-75,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
四川省医学会科研项目(Q14029)
泸州市科技计划项目[2016-S-60(2/3)]。
关键词
基因多态性
创伤
疼痛
Gene polymorphism
Trauma
Pain
