G211T突变与吗啡治疗癌痛有效性及安全性的相关性研究

中国药物警戒 ›› 2017, Vol. 14 ›› Issue (1): 14-18.

G211T突变与吗啡治疗癌痛有效性及安全性的相关性研究

吴楠, 张东蕾, 王蕾, 丁年羊, 李婕, 杨扬, 燕丹, 童本定, 魏青

江苏省肿瘤医院,江苏南京 210009

收稿日期:2017-02-16 修回日期:2017-02-16 出版日期:2017-01-20 发布日期:2017-02-16
作者简介:吴楠,女,硕士,主管药师,临床药学。
基金资助:
南京市科技发展计划（药学项目）（2012YX005）

Study on the Correlation between G211T Mutation and the Efficacy and Safety of Morphine Treatment on Cancer Pain

WU Nan, ZHANG Dong-lei, WANG Lei, DING Nian-yang, LI Jie YANG, Yang YAN, Dan TONG, Ben-ding, WEI Qing

Jiangsu Cancer Hospital, Jiangsu Nanjing 210009, China

Received:2017-02-16 Revised:2017-02-16 Online:2017-01-20 Published:2017-02-16

摘要/Abstract

摘要： 目的了解癌痛患者UGT2B7基因多态性的分布频率,探讨UGT2B7*1 G211T突变与吗啡对癌痛治疗效果及不良反应的相关性。方法对中重度癌痛患者给予吗啡镇痛治疗,采用数字分级法（NRS）进行疼痛评估,记录疼痛缓解所需吗啡剂量及药品不良反应发生情况。检测癌痛患者UGT2B7*1 211位点基因型,评价UGT2B7*1 G211T突变与吗啡用量以及不良反应的相关性。结果在中国癌痛人群中,UGT2B7*1 211位点基因型的野生型（GG）频率最高（68.60%）,突变杂合子（GT）频率次之（24.42%）,突变纯合子型（TT）频率最低（6.98%）。UGT2B7*1 G211T突变组（即GT组+TT组）与未突变组（GG组）比较,突变组疼痛缓解所需吗啡剂量高于未突变组（P<0.05）,突变组眩晕以及2级以上便秘的发生率高于未突变组（P<0.05）。结论UGT2B7*1 G211T基因多态性与吗啡镇痛剂量及安全性存在相关性。

关键词: 癌痛, 吗啡, UGT2B7, 基因多态性

Abstract: Objective To study the distribution frequency of UGT2B7 gene polymorphism in patients with cancer pain, and evaluate the effect of UGT2B7 * 1 G211T polymorphisms on the effect and safety of morphine. Methods Patients with moderate-severe cancer pain were treated with morphine,the numerical rating scale（NRS）was used for pain evaluation. Treatment data and adverse effects were recorded and UGT2B7 gene polymorphism was detected. According to the genotype and morphine dose, the impact of UGT2B7*1 G211T mutation on morphine analgesia efficacy and safety were evaluated. Results There were 68.60% patients with wild-type UGT2B7*1 G211G, 24.42% patients with heterozygous mutation UGT2B7*1 G211T and 6.98% patients with homozygous mutant UGT2B7*1 T211T in Chinese patients with cancer pain. UGT2B7*1 G211T mutation group (ie group GT+ group TT) needed higher doses of morphine than GG group（P <0.05）. Dizziness and grade 2~3 constipation happened more frequently in the UGT2B7*1 G211T mutation group (ie group GT+ group TT) than the wild-type group (group GG) ( P <0.05). Conclusion UGT2B7*1 G211T polymorphisms have impact on analgesic effect and safety of morphine.

Key words: cancer pain, morphine, UGT2B7, polymorphism

中图分类号:

R969

吴楠, 张东蕾, 王蕾, 丁年羊, 李婕, 杨扬, 燕丹, 童本定, 魏青. G211T突变与吗啡治疗癌痛有效性及安全性的相关性研究[J]. 中国药物警戒, 2017, 14(1): 14-18.

WU Nan, ZHANG Dong-lei, WANG Lei, DING Nian-yang, LI Jie YANG, Yang YAN, Dan TONG, Ben-ding, WEI Qing. Study on the Correlation between G211T Mutation and the Efficacy and Safety of Morphine Treatment on Cancer Pain[J]. Chinese Journal of Pharmacovigilance, 2017, 14(1): 14-18.

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