Klinik für Anästhesiologie and Intensivmedizin, University of Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr. 55, D-45122 Essen, Germany.
Klinik für Anästhesiologie and Intensivmedizin, University of Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr. 55, D-45122 Essen, Germany.
Anaesth Crit Care Pain Med. 2020 Feb;39(1):45-51. doi: 10.1016/j.accpm.2019.04.012. Epub 2019 May 8.
Clinical risk factors for postoperative nausea and vomiting (PONV) are usually stratified using the Apfel Score. While a genetic predisposition has recently been demonstrated with the muscarinic acetylcholine receptor (CHRM3) rs2165870 single nucleotide polymorphism (SNP), we investigated whether (1) other SNPs contribute to PONV risk and (2) a genetic risk score might summarise genetic PONV risk.
We retrospectively analysed data from a study with 472 patients undergoing elective surgery. We investigated the SNPs rs3218315 (IL2RB), rs349358 (KCNB2), rs703363 (intergenic variant), rs1800497 (DRD2), rs1799971 (OPRM1), and rs1176713 (HTR3A). A genetic risk score was established and association with PONV investigated.
Early PONV occurred in 37%. There was a significant association of the KCNB2 rs349358 SNP with nausea (P = 0.021), retching (P = 0.001), and PONV (P = 0.006). The rs349358 genotype distribution was TT in 310 and TC/CC in 155 patients. The KCNB2 SNP was associated with an Odds Ratio (OR) of 1.6 for CT/CC vs. TT (95% CI 1-2.5; P = 0.031) to develop PONV and this was independent from the Apfel Score, and the CHRM3 rs2165870 SNP. A genetic risk score based on the CHRM3 rs2165870 and the KCNB2 rs349358 SNP was created and this genetic score (OR per genetic risk score point: 1.6 (1.3-2.1), P < 0.0001) was independent from the Apfel Score (OR per Apfel score point: 1.6 (1.3-1.9), P < 0.0001) associated with PONV.
The KCNB2 rs349358 SNP is also an independent PONV predictor and a genetic risk score has a similar impact on PONV susceptibility compared to the Apfel Score.
术后恶心呕吐（PONV）的临床危险因素通常使用阿佩尔评分进行分层。虽然最近已经证明毒蕈碱乙酰胆碱受体（CHRM3）rs2165870 单核苷酸多态性（SNP）存在遗传易感性，但我们研究了（1）其他 SNP 是否会增加 PONV 风险，以及（2）遗传风险评分是否可以概括遗传 PONV 风险。
我们回顾性分析了一项纳入 472 例择期手术患者的研究数据。我们研究了 SNPs rs3218315（IL2RB）、rs349358（KCNB2）、rs703363（基因间变异）、rs1800497（DRD2）、rs1799971（OPRM1）和 rs1176713（HTR3A）。建立了遗传风险评分，并对其与 PONV 的相关性进行了研究。
PONV 早期发生在 37%的患者中。KCNB2 rs349358 SNP 与恶心（P=0.021）、呕吐（P=0.001）和 PONV（P=0.006）显著相关。rs349358 基因型分布为 TT 型 310 例，TC/CC 型 155 例。KCNB2 SNP 与 CT/CC 与 TT 相比，发生 PONV 的优势比（OR）为 1.6（95%CI 1-2.5；P=0.031），且独立于 Apfel 评分和 CHRM3 rs2165870 SNP。基于 CHRM3 rs2165870 和 KCNB2 rs349358 SNP 建立了遗传风险评分，该遗传评分（每遗传风险评分点增加 1 分的 OR：1.6（1.3-2.1），P<0.0001）独立于 Apfel 评分（每 Apfel 评分点增加 1 分的 OR：1.6（1.3-1.9），P<0.0001）与 PONV 相关。
KCNB2 rs349358 SNP 也是 PONV 的独立预测因子，遗传风险评分对 PONV 易感性的影响与 Apfel 评分相似。
