Yuan Jing-Jing, Ma Xiao-Jing, Li Zhi-Song, Chang Yan-Zi, Zhang Wei, Kan Quan-Cheng, Hou Jun-Kai, Zhang Li-Rong
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China.
Key Laboratory of Pharmacogenomics, No.1 East-JianShe Road, Zhengzhou, Henan Province, 450052, China.
BMC Med Genet. 2016 Nov 23;17(1):87. doi: 10.1186/s12881-016-0348-5.
The purpose of the study was to investigate the effects of the pregnane X receptor (PXR)*1B polymorphisms on CYP3A4 enzyme activity and postoperative fentanyl consumption in Chinese patients undergoing gynecological surgery.
A total of 287 females of Han ethnicity, aged 20 to 50 years old, ASA I or II, scheduled to abdominal total hysterectomy or myomectomy under general anesthesia were enrolled. The analgesic model used was fentanyl consumption via patient-controlled intravenous analgesia (PCIA) in the post-operative period. Additionally, pain was assessed using a visual analog score (VAS). Pain scores, occurrence of adverse reactions and consumption of fentanyl were recorded during the 24 h postoperative period. The enzyme activity of CYP3A4 was evaluated by measuring the plasma ratio of 1'-hydroxymidazolam to midazolam 1 h after intravenous administration of 0.1 mg/kg midazolam. PXR genotyping was performed by direct DNA sequencing and the PXR 1B haplotype was analyzed via PHASE V.2.1 software.
The polymorphism frequency of PXR11156A > C/11193 T > C and 8055C > T were 49.6 and 49.3%, and the rate of PXR 1B haplotype was 48.8% in our study. None of the pain scores, consumption of fentanyl 24 h post-operatively or enzyme activity of CYP3A4, showed differences among different genotypes.
PXR11156A > C, PXR11193T > C, PXR8055C > T or the PXR 1B haplotype do not appear to be important factors contributing to CYP3A4 activity and interindividual variations in postoperative fentanyl consumption in Han female patients undergoing gynecological surgery.
The DNA samples were obtained since 2007 to 2010 year in our hospital, there was no registration at that time. So this section is not applicable to our research.
本研究旨在探讨孕烷X受体（PXR）*1B基因多态性对中国妇科手术患者CYP3A4酶活性及术后芬太尼用量的影响。
选取287例年龄在20至50岁之间、美国麻醉医师协会（ASA）分级为I或II级、计划在全身麻醉下行腹式全子宫切除术或子宫肌瘤切除术的汉族女性患者。采用的镇痛模式为术后通过患者自控静脉镇痛（PCIA）使用芬太尼。此外，使用视觉模拟评分（VAS）评估疼痛程度。记录术后24小时内的疼痛评分、不良反应发生情况及芬太尼用量。静脉注射0.1mg/kg咪达唑仑1小时后，通过测量血浆中1'-羟基咪达唑仑与咪达唑仑的比值来评估CYP3A4的酶活性。通过直接DNA测序进行PXR基因分型，并使用PHASE V.2.1软件分析PXR 1B单倍型。
在本研究中，PXR11156A＞C/11193T＞C和8055C＞T的多态性频率分别为49.6%和49.3%，PXR 1B单倍型频率为48.8%。不同基因型之间的疼痛评分、术后24小时芬太尼用量或CYP3A4酶活性均无差异。
PXR11156A＞C, PXR11193T＞C, PXR8055C＞T或PXR 1B单倍型似乎并非影响汉族妇科手术女性患者CYP3A4活性及术后芬太尼用量个体差异的重要因素。
本研究的DNA样本于2007年至2010年在我院采集，当时未进行注册。因此，此部分不适用于本研究。
