摘要
目的探讨影响预防性使用帕洛诺司琼对腹腔镜子宫切除手术术后恶心呕吐(PONV)效果的遗传相关因素。方法 75例全身麻醉下行腹腔镜子宫切除术的患者,诱导前抽取外周全血,对术后24 h内恶心呕吐进行评分,54例患者术后完全未发生恶心呕吐即为CR组,21例患者出现恶心或呕吐即为NV组。外周全血DNA进行Sanger测序,对SLC6A4 rs1042173,ABCB1 rs1045642和CYP3A5 rs776746 3个位点的等位基因进行分型,使用Fisher确切概率法比较两组患者3个等位基因携带频率,评估遗传位点多态性对使用帕洛诺司琼预防PONV效果的影响。结果突变型rs1042173 C→A基因型显著富集于CR组,携带等位基因A的术后患者对帕罗诺司琼的完全有效有效率高于野生型,为野生型的11.36倍[比值比(OR)=11.36,P<0.01];突变型rs1045642 G→A基因型显著富集于NV组,野生型G/G的患者对帕罗诺司琼的完全有效有效率高于携带等位基因A的患者,为后者的20.16倍(OR=20.16,P<0.01);突变型rs776746 C→T基因型显著富集于NV组,野生型C/C的患者对帕罗诺司琼的完全有效有效率高于携带等位基因T的患者,为后者的7.91倍(OR=7.91,P<0.01)。结论腹腔镜子宫切除术预防性使用帕洛诺司琼的效果受SLC6A4 rs1042173、ABCB1 rs1045642和CYP3A5 rs776746多态性的影响。
Objective To explore the impact of genetic risk factors of the effect on postoperative nausea and vomiting(PONV)after laparoscopic hysterectomy using of palonosetron.Methods 75 patients undergoing laparoscopic hysterectomy under general anesthesia were selected.The peripheral blood samples were taken before induction,and the nausea and vomiting statistics within 24 hours after operation were analysis.54 patients had no nausea and vomiting within 24 hours,namely complete response(CR)group,and 21 patients had nausea or vomiting,namely nausea and vomiting(NV)group.Sanger sequencing was performed on peripheral whole blood DNA.The alleles of SLC6A4 rs1042173,ABCB1 rs1045642 and CYP3A5 rs776746 were genotyped.The carrying frequencies of three alleles in the two groups were compared to evaluate the effect of genetic polymorphism on the prevention of postoperative nausea and vomiting with palonosetron.Results Mutant rs1042173 C→A genotype was significantly enriched in CR group.The complete effective rate of postoperative patients with allele A was 11.36 times higher than that of wild type[odds ratio(OR)=11.36,P<0.01].Mutant rs1045642 G→A genotype was significantly enriched in NV group,the complete effective rate of wild type G/G patients to palonosetron was 20.16 times higher than that of patients with allele A(OR=20.16,P<0.01),the mutant rs776746 C→T genotype was significantly enriched in NV group,and the complete effective rate of wild-type C/C patients to palonosetron was 7.91 times higher than that of patients with allele T(OR=7.91,P<0.01).Conclusion The effect of palonosetron is affected by SLC6A4 rs1042173,ABCB1 rs1045642 and CYP3A5 rs776746 polymorphisms in the women during laparoscopic hysterectomy.
作者
赵颖莹
王海涛
薛琼
李会娟
艾艳秋
杨建军
Zhao Yingying;Wang Haitao;Xue Qiong;Li Huijuan;Ai Yanqiu;Yang Jianjun(Department of Anesthesiaology,Pain and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华实验外科杂志》
CAS
北大核心
2021年第11期2269-2272,共4页
Chinese Journal of Experimental Surgery
关键词
帕洛诺司琼
基因
携带
术后恶心呕吐
Palonosetron
Gene
Carrying
Postoperative nausea and vomiting
