【摘要】 目的探讨细胞色素P450(CYP)2A6及CYP2B6等位基因多态性与丙戊酸钠血药浓度的关系。方法选择165例服用丙戊酸钠单药治疗且无肝肾功能异常的癫疒间患者,应用多聚酶链反应(PCR)方法分别进行CYP2A6(95例)和CYP2B6(70例)等位基因多态性频率分析;应用荧光偏振免疫法(FPIA)测定含不同等位基因患者丙戊酸钠的血药浓度。结果95例患者中,CYP 2A6*4等位基因频率为13.2%,CYP2A6*4等位基因携带者丙戊酸钠的血药浓度[(4.23±0.27)mg/ml]明显高于非CYP2A6*4等位基因携带者[(3.35±0.38)mg/ml](P<0.05);70例患者中,CYP2B6*6等位基因频率为24.3%,CYP2B6*6等位基因携带者丙戊酸钠的血药浓度[(4.12±0.34)mg/ml]明显高于非CYP2B6*6等位基因携带者[(3.07±0.28)mg/ml](P<0.05)。结论CYP2A6或(和)CYP2B6等位基因多态性均影响丙戊酸钠的血药浓度,CYP2A6*4或(和)CYP2B6*6等位基因携带者丙戊酸钠用量应低于常规剂量,以减少不良反应的发生和避免药物资源的浪费。更多还原

【Abstract】 Objective To investigate the correlation between the alleles polymorphism of CYP2A6 and CYP2B6 and blood concentration of Valproate sodium(VPA).Methods The 165 epilepsy patients received simplex VPA and without dysfunction of liver and kidney were chose in this study.The alleles polymorphism of CYP2A6 in 95 cases and CYP2B6 in 70 cases were detected by polymerase chain reaction(PCR).Fluorescence polarization immunoassay(FPIA) was used to measure the blood concentration of VPA.Results The frequence of allele CYP2A6*4 in 95 cases was 13.2%.The blood concentration of VPA in patients with allele CYP2A6*4[(4.23±0.27)mg/ml]was significantly higher than that in patients without allele CYP2A6*4[(3.35±0.38)mg/ml](P<0.05).The frequence of allele CYP2B6*6 was 24.3%.The blood concentration of VPA in patients with allele CYP2B6*6 [(4.12±0.34)mg/ml] was significantly higher than that in patients without allele CYP2B6*6[(3.07±0.28)mg/ml](P<0.05).Conclusions The blood concentration of VPA is affected by the genetic polymorphisms of CYP2A6 or(and) CYP2B6.The dosage of Valproate sodium in patients harboring alleles CYP2A6*4 or/and CYP2B6*6 shall be lower than usual to prevent the adverse effect and wasting the medicine resource.更多还原