NK1受体基因多态性与腹腔镜手术PONV的相关性分析(1)
【摘要】 目的：探讨NK1受体基因多态性与妇科腹腔镜患者術后恶心呕吐(PONV)发生率的相关性。方法：选择80例择期全麻妇科腹腔镜手术患者，年龄18～65岁。术前采集外周静脉血5 mL，使用基因组DNA提取试剂盒抽取DNA，运用等位基因特异扩增法进行NK1受体基因分型，采用DNA测序仪直接测序对NK1受体的单核苷酸基因多态性进行分型。观察患者术后恶心呕吐发生频率和时间、恶心评分、疼痛评分、镇痛药物用量、止吐药的使用情况等。在本研究中呕吐和干呕均视为呕吐事件，并记录患者术中术后循环状态及其他不良反应的情况。结果：按照单核苷酸基因变异位点筛选出，野生型纯合子(wt/wt组)21例(26.3%)，杂合子(wt/mut组)25例(31.3%)，突变基因型纯合子(mut/mut组)34例(42.5%)，mut/mut组6例发生PONV，发生率为17.6%，其发生率低于其他两组(P<0.05)。结论：NK1受体基因多态性与中国女性人群PONV发生率具有相关性，其中突变纯合子的PONV发生率较低。
【关键词】 NK1受体; PONV; 单核苷酸基因多态性
【Abstract】 Objective：To explore the relationship of common genomic variations of NK1 receptor gene and the incidence of postoperative vomiting in patients underwent laparoscopic surgery.Method：We conducted a prospective observational study design of 80 patients who underwent elective laparoscopic surgery，aged 18 to 65 years old. 5 mL peripheral blood before surgery was collected，genomic DNA extraction kit was used to extract DNA，allele-specific amplification was used to genotype NK1 receptor gene，and DNA sequencing was used to genotype single nucleotide polymorphism of NK1 receptor.The rates and time and score of nausea and vomiting were measured，and the VAS，the dosage of analgesic and antemetic were measured as well.Vomiting and retching were considered vomiting events in this study，we also recorded the circulation perioperative and the adverse reaction.Result：According to the variable sit of single nucleotide polymorphisms，we found three types，21 cases of homozygous wild type(wt/wt group，26.3%)，25 cases of mutant heterozygote(wt/mut group，31.3%)，34 cases of homozygous mutant(mut/mut group，42.5%).There were 6 patients had PONV in homozygous mutant group，the total incidence was 17.6% which was lower than the others(P<0.05).Conclusion：The genomic variations of the NK1 receptor gene has a relationship of postoperative vomiting and nausea in patients who underwent gynecological laparoscopic surgery，and the incidence of PONV in homozygous mutant is lower than those of the others.
【Key words】 NK1 receptor; PONV; Single nucleotide polymorphisms
First-author’s address：College of Fujian Provincial Hospital，Fujian Medical University，Fuzhou 350001，China
doi：10.3969/j.issn.1674-4985.2019.03.001
手术后恶心呕吐(postoperative nausea and vomiting，PONV)治疗手段效果有限，是围术期医学中困扰着麻醉科和外科医生的问题。PONV可诱发一系列并发症，但其与基因的关系尚不清楚。研究表明，P物质(SP)是由神经细胞和胃肠道内分泌细胞产生的内源性递质，存在于胃肠嗜铬细胞以及迷走神经、孤束核、极后区等呕吐产生的关键部位，与PONV关系密切[1-3]。而P物质与P物质受体1(NK1受体，NK1R)的亲和力最大，因此本研究拟研究NK1R基因多态性与腹腔镜手术PONV的相关性。现报道如下。, http://www.100md.com(邹聪华 郑晓春 陈烨)
【关键词】 NK1受体; PONV; 单核苷酸基因多态性
【Abstract】 Objective：To explore the relationship of common genomic variations of NK1 receptor gene and the incidence of postoperative vomiting in patients underwent laparoscopic surgery.Method：We conducted a prospective observational study design of 80 patients who underwent elective laparoscopic surgery，aged 18 to 65 years old. 5 mL peripheral blood before surgery was collected，genomic DNA extraction kit was used to extract DNA，allele-specific amplification was used to genotype NK1 receptor gene，and DNA sequencing was used to genotype single nucleotide polymorphism of NK1 receptor.The rates and time and score of nausea and vomiting were measured，and the VAS，the dosage of analgesic and antemetic were measured as well.Vomiting and retching were considered vomiting events in this study，we also recorded the circulation perioperative and the adverse reaction.Result：According to the variable sit of single nucleotide polymorphisms，we found three types，21 cases of homozygous wild type(wt/wt group，26.3%)，25 cases of mutant heterozygote(wt/mut group，31.3%)，34 cases of homozygous mutant(mut/mut group，42.5%).There were 6 patients had PONV in homozygous mutant group，the total incidence was 17.6% which was lower than the others(P<0.05).Conclusion：The genomic variations of the NK1 receptor gene has a relationship of postoperative vomiting and nausea in patients who underwent gynecological laparoscopic surgery，and the incidence of PONV in homozygous mutant is lower than those of the others.
【Key words】 NK1 receptor; PONV; Single nucleotide polymorphisms
First-author’s address：College of Fujian Provincial Hospital，Fujian Medical University，Fuzhou 350001，China
doi：10.3969/j.issn.1674-4985.2019.03.001
手术后恶心呕吐(postoperative nausea and vomiting，PONV)治疗手段效果有限，是围术期医学中困扰着麻醉科和外科医生的问题。PONV可诱发一系列并发症，但其与基因的关系尚不清楚。研究表明，P物质(SP)是由神经细胞和胃肠道内分泌细胞产生的内源性递质，存在于胃肠嗜铬细胞以及迷走神经、孤束核、极后区等呕吐产生的关键部位，与PONV关系密切[1-3]。而P物质与P物质受体1(NK1受体，NK1R)的亲和力最大，因此本研究拟研究NK1R基因多态性与腹腔镜手术PONV的相关性。现报道如下。, http://www.100md.com(邹聪华 郑晓春 陈烨)