Department of Orthopaedic Surgery, Detroit Medical Center, Detroit; Department of Research, Fajr Scientific, Ann Arbor, Michigan.
Department of Emergency Medicine, HCA Aventura Hospital, Aventura, Florida.
J Opioid Manag. 2024 Jan-Feb;20(1):77-85. doi: 10.5055/jom.0809.
Orthopedic surgical procedures are expected to increase annually, making it imperative to understand the correlations between patient genetic makeup and post-operative pain levels.
We performed a systematic literature review using PubMed and Cochrane databases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 299 articles were initially selected, 20 articles remained after title and abstract review, and nine articles were selected for inclusion upon full text review.
Genetic risk factors identified included the A allele of the 5HT2A gene single nucleotide polymorphism, the AA genotype of the ADRB2 gene, the CG genotype of the IL6 gene, the genotypes CT and TT of the NTRK1 gene, genotypes AA and GA of the OPRM gene, and the AA and GA genotypes of the COMT gene. Additional studies in the review discuss statistical significance of other variants of the COMT gene.
There have been genetic association studies performed on the patient heterogeneity and its relationship on patient pain levels, but more data need to be collected to understand the clinical utility of stratifying patients based on genomic sequence.
骨科手术预计每年都会增加，因此了解患者基因构成与术后疼痛程度之间的相关性至关重要。
我们按照系统评价和荟萃分析的首选报告项目的要求，使用 PubMed 和 Cochrane 数据库进行了系统文献回顾。最初共选择了 299 篇文章，经过标题和摘要审查后，有 20 篇文章保留，经过全文审查后，有 9 篇文章入选。
确定的遗传风险因素包括 5HT2A 基因单核苷酸多态性的 A 等位基因、ADRB2 基因的 AA 基因型、IL6 基因的 CG 基因型、NTRK1 基因的 CT 和 TT 基因型、OPRM 基因的 AA 和 GA 基因型以及 COMT 基因的 AA 和 GA 基因型。该综述中的其他研究还讨论了 COMT 基因其他变体的统计学意义。
已经对患者异质性及其与患者疼痛程度的关系进行了遗传相关性研究，但需要收集更多的数据，以了解根据基因组序列对患者进行分层的临床应用。
