基因变异对重大乳腺手术患者芬太尼代谢的影响：一项候选基因关联研究。
Impact of genetic variants on fentanyl metabolism in major breast surgery patients: a candidate gene association study.
作者信息
Kumar Shathish, Ramasamy Kesavan, Natarajan Harivenkatesh, Venkatraman Shravan, Eriyat Vishnu, Kundra Pankaj
机构信息
Department of Anaesthesiology, Manipal Hospital Whitefield, Bangalore, India.
Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
出版信息
Pharmacogenomics. 2024;25(14-15):595-603. doi: 10.1080/14622416.2024.2429365. Epub 2024 Nov 20.
AIM
The study aimed to examine the association of two selected candidate SNPs rs2242480 (CYP3A4) and rs1045642 (ABCB1) with metabolic ratio of plasma norfentanyl to fentanyl concentrations in patients undergoing major breast surgeries.
METHODS
The retrospective cross-sectional study was done in 257 female patients. DNA extraction, genotyping of selected SNPs, and drug levels measurement were employed.
RESULTS
A total of 257 female patients were recruited with no loss to follow up. There was no significant association between the two mentioned SNPs and the metabolic ratio ( value > 0.05). As an exploratory analysis, there was a moderately significant negative correlation between metabolic ratio and pupillary constriction to fentanyl ( = -0.27; < 0.001). There was also a weak but significant positive correlation between metabolic ratio and time for first analgesia in the postoperative period ( = 0.17; = 0.01).
CONCLUSION
There was no significant association with the selected candidate SNPs in and and metabolic ratio of norfentanyl to fentanyl in South Indian patients undergoing major breast surgery.
目的
本研究旨在探讨两个选定的候选单核苷酸多态性（SNP），即rs2242480（CYP3A4）和rs1045642（ABCB1）与接受大型乳房手术患者血浆中去甲芬太尼与芬太尼浓度代谢比之间的关联。
方法
对257名女性患者进行了回顾性横断面研究。采用了DNA提取、选定SNP的基因分型以及药物水平测量。
结果
共招募了257名女性患者，无失访情况。上述两个SNP与代谢比之间无显著关联（P值>0.05）。作为探索性分析，代谢比与对芬太尼的瞳孔收缩之间存在中度显著的负相关（r = -0.27；P < 0.001）。代谢比与术后首次镇痛时间之间也存在微弱但显著的正相关（r = 0.17；P = 0.01）。
结论
在接受大型乳房手术的南印度患者中，CYP3A4和ABCB1中选定的候选SNP与去甲芬太尼与芬太尼的代谢比无显著关联。
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