【摘要】 目的 探讨CYP3A4*1G基因多态性对异丙酚联合瑞芬太尼在宫颈癌切除手术麻醉效果的影响。方法 采用聚合酶链式反应（PCR）和限制性内切片段长度多态性（RFLP）法（PCR-RFLP）对106例宫颈癌患者外周血单个核细胞CYP3A4*1G基因位点等位基因分布进行分析，采用多因素方差分析对基因型分布和麻醉剂用量进行分析。此外，采用独立样本t检验分析基因多态性影响因素（吸烟和饮酒）与麻醉剂用量的相关性。比较不同基因型患者的视觉模拟评分（VAS）及麻醉诱导和恢复时间。采用方差分析检测基因多态性对拔管后血流动力学的影响。结果 饮酒和高血压与CYP3A4*1G基因多态性具有相关性（P<0.05）。饮酒和高血压对宫颈癌手术异丙酚联用瑞芬太尼用量均有显著影响（P<0.05）。宫颈癌手术患者，AA基因型的麻醉诱导时间、呼吸恢复时间、睁眼时间、气管导管拔出时间均显著短于GA和GG型，差异均有统计学意义（P<0.05）。AA基因型患者拔管后0、1、2、3、4 min收缩压和心率均低于GG基因型患者，差异有统计学意义（P<0.05）。结论 CYP3A4*1G基因多态性可影响异丙酚联合瑞芬太尼治疗宫颈癌手术的麻醉效果。更多还原

【Abstract】 Objective The aim of this study is to determine the influences of CYP3A4*1G gene polymorphisms on the anesthetic effect of propofol combined with remifentanil in the resection of cervical cancer. Methods The allele distribution at the gene locus CYP3A4*1G in peripheral blood cells of 106 patients with cervical cancer was analyzed via reverse transcription-polymerase chain reaction(RT-PCR), the genetic equilibrium was detected using the TaqMan genotyping technique, and the multivariate analysis of variance was adopted for the genotype distribution and dosage of anesthetics. Moreover, the correlations of the influencing factors of gene polymorphisms(smoking and drinking) with the dosage of anesthetics were analyzed using the independent-samples t test. The visual analogue scale(VAS) score of patients with different genotypes and the time of anesthesia induction and recovery were measured and compared. The effects of gene polymorphisms on hemodynamics after extubation were detected using the analysis of variance. Results Alcohol consumption and hypertension are correlated with CYP3A4*1G gene polymorphism(P<0.05). Both alcohol consumption and hypertension have a significant impact on the dosage of propofol combined with remifentanil during cervical cancer surgery(P<0.05). The anesthesia induction time, respiratory recovery time, eye opening time, and laryngeal mask removal time of AA genotype patients undergoing cervical cancer surgery were significantly shorter than those of GA and GG genotypes,and the differences were statistically significant(P<0.05). The systolic blood pressure and heart rate of AA genotype patients were lower than those of GG genotype patients at 0, 1, 2, 3, and 4 minutes after extubation, and the difference was statistically significant(P<0.05). Conclusion CYP3A4*1G gene polymorphisms can affect the anesthetic effect of propofol combined with remifentanil in cervical cancer.更多还原