摘要
Abstract
OBJECTIVE:To investigate the effects of multidrug resistance gene 1(MDR1)C3435T polymorphism on the dose of analgesia agents(dezocine combined with sufentanil)after joint replacement. METHODS:300 patients receiving joint replace-ment were selected from Tianjin People's Hospital and Tianjin Port Hospital during Jan. 2014-Feb. 2016. They were given dezocine and sufentanil for postoperative analgesia. PCR-RFLP was used to determine MDR1 C3435T polymorphism;VAS scores,Ramesy scores,the dose of dezocine+sufentanil and the occurrence of ADR were compared among different genotypes. RESULTS:Among 300 patients,there were 100(33.3%),102(34.0%)and 98(32.7%)cases of MDR1 C3435T CC,CT and TT genotype,respec-tively,the frequencies of which were all in line with Hardy-Weinberg balance (P>0.05). There was no statistical significance in VAS scores and Ramesy scores among different genotypes 0,24,48 h after surgery(P>0.05). No excessive sedation was found. The dose of dezocine+sufentanil in CT and TT genotype were all significantly lower than CC genotype 0-24 h,>24-48 h after sur-gery,with statistical significance(P<0.05). There was no statistical significance in drug dose between CT and TT genotype during above periods (P>0.05). The incidence of postoperative nausea and vomiting (PONV),ADR in TT genotype were significantly lower than CC and CT genotypes,with statistical significance (P<0.05). There was no statistical significance in the incidence of PONV and ADR between CC genotype and CT genotype,and in the incidence of itch among different genotypes(P>0.05). CON-CLUSIONS:With similar sedation and analgesic effect,MDR1 mutant type have lower resistance to dezocine+sufentanil,and smaller drug dose is need,the incidence of ADR is lower. MDR1 genotype can be regarded as an important indicator of clinical in-dividualized treatment.关键词
MDR1/基因多态性/关节置换术/术后镇痛/地佐辛/舒芬太尼/使用量/VAS评分/Ramesy评分Key words
MDR1/Gene polymorphism/Joint replacement/Postoperative analgesia/Dezocine/Sufentanil/Dose/VAS score/Ramesy score分类
医药卫生
