细胞因子的基因多态性可能影响患者术后舒芬太尼的镇痛剂量。

Genetic Polymorphisms of Cytokines Might Affect Postoperative Sufentanil Dosage for Analgesia in Patients.

作者信息

Guo Jian, Yuan Fei, Yang Yixin, Li Yunze, Bao Fangping, Guo Xuejiao, Feng Zhiying

机构信息

Department of Pain Medicine, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, People's Republic of China.

Department of Anesthesiology, The Fourth Affiliated Hospital, Zhejiang University, School of Medicine, Yiwu, Zhejiang 322000, People's Republic of China.

出版信息

J Pain Res. 2020 Jun 16;13:1461-1470. doi: 10.2147/JPR.S250174. eCollection 2020.

DOI:10.2147/JPR.S250174

PMID:32606912

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7305826/

Abstract

OBJECTIVE

To explore the effect of genetic polymorphisms of cytokines on the dosage of sufentanil for patient-controlled intravenous analgesia (PCIA) after radical lung cancer surgery.

METHODS

A total of 100 patients, aged 18 years and above, with ASA grade Ⅰ-Ⅱ and body mass index (BMI) 18.5 to 30, and who were scheduled for radical lung cancer surgery under total intravenous anaesthesia with PCIA of sufentanil from September 2015 to March 2016, were selected. DNA was collected from peripheral blood samples before surgery, and the iMLDRTM multiple single-nucleotide polymorphism typing kit was used to detect 16 related single-nucleotide polymorphism (SNP) sites of interleukin-1A (IL-1A), interleukin-1β (IL-1β), interleukin-1RN (IL-1RN), interleukin-6 (IL-6), C-X-C motif chemokine ligand 8 (CXCL8), interleukin-10 (IL-10), tumour necrosis factor (TNF), nuclear factor kappa-B1 (NFκB1), REL (REL proto-oncogene, NF-kB subunit), and nuclear factor kappa-B inhibitor alpha (NFκBIA). The general characteristics of patients, surgery and anaesthesia data, postoperative resting VAS pain scores, postoperative opioid dosages of sufentanil for PCIA and opioid-related adverse events were recorded. The effects of the examined genetic polymorphisms of the cytokines on the dosage of sufentanil were analysed.

RESULTS

Eight of 100 patients withdrew for various reasons, and, eventually, 92 patients were included. The patients' resting visual analogue scale (VAS) scores at 24 h, 48 h, and 72 h after surgery were 2.3 ± 1.2, 2.0 ± 0.9, and 1.9 ± 1.0, respectively. The total amounts of sufentanil used were 34.7 ± 10.5 μg, 65.2 ± 13.7 μg, and 94.7 ± 11.6 μg, respectively. We found that the TT genotype of NFκBIA rs696 had higher PCIA sufentanil dosages than the CC genotype and the CT genotype at 48-72 h postoperation (p=0.023, p=0.025, respectively).

CONCLUSION

The genetic polymorphisms of the cytokine NFκBIA rs696 might affect the dosage of sufentanil for PCIA after radical lung cancer surgery. The specific mechanism needs further study.

摘要

目的

探讨细胞因子基因多态性对肺癌根治术后患者自控静脉镇痛（PCIA）中舒芬太尼用量的影响。

方法

选取2015年9月至2016年3月计划在全凭静脉麻醉下行肺癌根治术并采用舒芬太尼PCIA的100例18岁及以上、ASA分级Ⅰ - Ⅱ级、体重指数（BMI）18.5至30的患者。术前采集外周血样本提取DNA，采用iMLDRTM多重单核苷酸多态性分型试剂盒检测白细胞介素 - 1A（IL - 1A）、白细胞介素 - 1β（IL - 1β）、白细胞介素 - 1受体拮抗剂（IL - 1RN）、白细胞介素 - 6（IL - 6）、C - X - C基序趋化因子配体8（CXCL8）、白细胞介素 - 10（IL - 10）、肿瘤坏死因子（TNF）、核因子κB1（NFκB1）、REL（REL原癌基因，NF - κB亚基）和核因子κB抑制因子α（NFκBIA）的16个相关单核苷酸多态性（SNP）位点。记录患者的一般特征、手术和麻醉数据、术后静息时视觉模拟评分（VAS）疼痛评分、PCIA中舒芬太尼的术后阿片类药物用量及阿片类药物相关不良事件。分析所检测的细胞因子基因多态性对舒芬太尼用量的影响。

结果

100例患者中有8例因各种原因退出，最终纳入92例患者。术后24 h、48 h和72 h患者的静息视觉模拟量表（VAS）评分分别为2.3±1.2、2.0±0.9和1.9±1.0。舒芬太尼的总用量分别为34.7±10.5μg、65.2±13.7μg和94.7±11.6μg。我们发现，术后48 - 72 h，NFκBIA rs696的TT基因型PCIA舒芬太尼用量高于CC基因型和CT基因型（分别为p = 0.023，p = 0.025）。