%0 Journal Article
%T COMT V158M基因多态性对术后患者舒芬太尼镇痛效果的影响
%A 张洁　张雪莹　夏婧　梁永新　褚海辰
%J -
%D 2019
%R 10.13362/j.jpmed.201906009
%X 摘要 目的　评价儿茶酚氧位甲基转移酶COMT V158M基因多态性对术后患者舒芬太尼镇痛效果的影响。 方法　选择2017年11月－2018年10月拟行全身麻醉下胸腔镜肺叶切除术患者100例,年龄18～60岁，ASA分级Ⅱ或Ⅲ级，术前对基因突变性进行检测，并按照基因型分为野生型纯合子组（VV组）、突变型杂合子组（VM组）和突变型纯合子组（MM组）。术后使用舒芬太尼患者自控静脉镇痛（PCIA）。记录患者术后24与48 h时视觉模拟评分法（VAS）评分、术后舒芬太尼用量和术后24 h睡眠质量评分和状态特质焦虑量评分。 结果　与VV及VM组相比，MM组术后24、48 h时VAS评分和舒芬太尼用量明显减低或减少（F=4.099~7.722,P＜0.05)；三组睡眠质量评分及状态特质焦虑量表评分比较差异无统计学意义（P＞0.05）。 结论　COMT V158M基因多态性可能是舒芬太尼术后患者镇痛效果不同的机制之一。<br>Abstract：Objective　To evaluate the influence of catechol-O-methyl transferase COMT V158M polymorphism on the analgesic effect of sufentanil in postoperative patients. Methods　This study included 100 American Society of Anesthesiologists physical status Ⅱ or Ⅲ patient aged 18-60 years, who planned to undergo thoracoscopic lobectomy under general anesthesia from November 2017 to October 2018. According to the results of gene mutation detection conducted before operation, these patients were divided into wild-type homozygote group (VV group), mutant heterozygote (VM group), and mutant homozygote group (MM group). Sufentanil was used for patient-controlled intravenous analgesia postoperatively. Visual Analogue Scale (VAS) scores at 24 and 48 h after operation, postoperative sufentanil dose, and sleep quality score and State-Trait Anxiety score at 24 h after operation were recorded. Results　Compared with the VV group and VM group, the MM group had significantly reduced VAS scores at 24 and 48 h after operation and postoperative sufentanil dose (F=4.099-7.722,P<0.05). There were no significant differences in sleep quality score and State-Trait Anxiety score between the three groups (P>0.05). Conclusion　COMT V158M polymorphism may be one of the factors that account for the difference in the analgesic effect of sufentanil in postoperative patients
%K 多态性
%K 单核苷酸
%K 儿茶酚O-甲基转移酶
%K 舒芬太尼
%K 镇痛<br>Polymorphism
%K single nucleotide
%K Catechol O-methyltransferase
%K Sufentanil
%K Analgesia
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.201906009