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多态性导致罗库溴铵在中国患者中的作用存在差异。

Polymorphisms contribute to differences in the effect of rocuronium in Chinese patients.

机构信息

Department of Anaesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Basic Clin Pharmacol Toxicol. 2022 Jan;130(1):141-150. doi: 10.1111/bcpt.13682. Epub 2021 Nov 10.

DOI:10.1111/bcpt.13682
PMID:34734679
Abstract

Rocuronium is widely utilized in clinical general anaesthesia, and individual differences in pharmacology and clearance have been observed. Two hundred thirty-six Chinese patients undergoing selective thyroid/breast mass resection were studied. Total intravenous anaesthesia was induced with a single dose of propofol (2 mg·kg ), sufentanil (0.5 μg·kg ), and rocuronium (0.6 mg·kg ) and maintained with propofol (3-5 mg·kg ·h ) and remifentanil (0.2-0.4 μg·kg ·min ). Intubation conditions and a train-of-four index of patients were utilized to assess the effects and duration of rocuronium. The data from 228 patients were analysed and reported. Genotypes NR1I2 rs2472677 C > T, NR1I2 rs6785049 G > A, SLCO1B1 rs4363657 T > C, SLCO1A2 rs4762699 T > C, and UGT1A1 rs4148323 G > A contributed to individual variation in rocuronium. Of the clinical variables tested, age, BMI, total dose of propofol, NR1I2 rs2472677, and SLCO1A2 rs4762699 correlated significantly (P < 0.05 for all) with the clinical duration or total clinical action time of rocuronium in a multiple linear regression model. No significant interactions were observed in intubation conditions. Genetic variations in NR1I2 rs2472677, NR1I2 rs6785049, SLCO1B1 rs4363657, SLCO1A2 rs4762699, and UGT1A1 rs4148323 were related to extensive interindividual variability in the clinical duration and total clinical action time of rocuronium.

摘要

罗库溴铵广泛应用于临床全身麻醉,其药代动力学和清除率存在个体差异。本研究纳入了 236 例接受甲状腺/乳腺肿块切除术的中国患者。患者均采用丙泊酚(2mg·kg -1 )、舒芬太尼(0.5μg·kg -1 )和罗库溴铵(0.6mg·kg -1 )单次诱导全身麻醉,以丙泊酚(3-5mg·kg -1 ·h -1 )和瑞芬太尼(0.2-0.4μg·kg -1 ·min -1 )维持麻醉。采用插管条件和肌松监测仪的四个成串刺激(TOF)指数评估罗库溴铵的药效和时效。共分析了 228 例患者的数据并进行报告。NR1I2 rs2472677 C > T、NR1I2 rs6785049 G > A、SLCO1B1 rs4363657 T > C、SLCO1A2 rs4762699 T > C 和 UGT1A1 rs4148323 G > A 等基因多态性与罗库溴铵的个体差异有关。在测试的临床变量中,年龄、BMI、丙泊酚总量、NR1I2 rs2472677 和 SLCO1A2 rs4762699 与罗库溴铵的临床时效或总临床作用时间呈显著相关(P 均<0.05)。在插管条件方面,未观察到显著的相互作用。NR1I2 rs2472677、NR1I2 rs6785049、SLCO1B1 rs4363657、SLCO1A2 rs4762699 和 UGT1A1 rs4148323 等基因多态性与罗库溴铵的临床时效和总临床作用时间存在广泛的个体间变异性有关。

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