Ma Jin, Li Wenyao, Chai Qing, Tan Xiaohong, Zhang Kexian
Department of Anesthesiology, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Medicine (Baltimore). 2019 Feb;98(7):e14445. doi: 10.1097/MD.0000000000014445.
The aim of this study was to investigate the association between purinergic receptor P2X7 (P2RX7) gene rs1718125 polymorphism and analgesic effect of fentanyl after surgery among patients with lung cancer in a Chinese Han population.A total of 238 patients with lung cancer who received resection were enrolled in our study. The genotype distributions of P2RX7 rs1718125 polymorphism were detected by polymerase chain reaction and direct sequencing. Postoperative analgesia was performed by patient-controlled intravenous analgesia, and the consumption of fentanyl was recorded. The postoperative pain was measured by visual analog scale (VAS). Differences in postoperative VAS score and postoperative fentanyl consumption for analgesia in different genotype groups were analyzed by analysis of variance assay.The frequencies of GG, GA, and AA genotypes were 46.22%, 44.96%, and 8.82%, respectively. After surgery, the postoperative VAS score of GA group was significantly high in the period of analepsia after general anesthesia and at 6 hours after surgery (P = .041 and P = .030, respectively), while AA group exhibited obviously high in the period of analepsia after general anesthesia (P < .001), at postoperative 6 hours (P = .006) and 24 hours (P = .016). Moreover, the patients carrying GA and AA genotypes needed more fentanyl to control pain within 48 hours after surgery (P < .05 for all).P2RX7 gene rs1718125 polymorphism is significantly associated with postoperative pain and fentanyl consumption in patients with lung cancer.
本研究旨在探讨嘌呤能受体P2X7（P2RX7）基因rs1718125多态性与中国汉族肺癌患者术后芬太尼镇痛效果之间的关联。本研究共纳入238例接受切除术的肺癌患者。采用聚合酶链反应和直接测序法检测P2RX7 rs1718125多态性的基因型分布。术后采用患者自控静脉镇痛，并记录芬太尼的用量。采用视觉模拟评分法（VAS）测量术后疼痛程度。采用方差分析比较不同基因型组术后VAS评分及术后芬太尼镇痛用量的差异。GG、GA和AA基因型的频率分别为46.22%、44.96%和8.82%。术后，GA组在全身麻醉苏醒期及术后6小时的术后VAS评分显著高于其他组（分别为P = 0.041和P = 0.030），而AA组在全身麻醉苏醒期（P < 0.001）、术后6小时（P = 0.006）和24小时（P = 0.016）的VAS评分明显较高。此外，携带GA和AA基因型的患者在术后48小时内需要更多的芬太尼来控制疼痛（均P < 0.05）。P2RX7基因rs1718125多态性与肺癌患者术后疼痛及芬太尼用量显著相关。
