细胞色素P450 CYP3A4-1G多态性对分娩镇痛舒芬太尼个体化用药的影响.pdfVIP

窑综 述 窑 中国医药导报 2014年6月第 11卷第 16期 细胞色素P450CYP3A4*1G多态性 对分娩镇痛舒芬太尼个体化用药的影响 张青林 首都医科大学附属北京妇产医院麻醉科袁北京 100026 [摘要] 目前袁舒芬太尼已逐步成为椎管内分娩镇痛的推荐药物袁在国内外也得到了广泛的应用遥 但较多文献报 道均认为袁舒芬太尼在产妇中的应用中存在着较大的个体差异袁它的常规应用剂量及浓度就能引起一些产妇出 现恶心呕吐尧胎心异常及宫缩亢奋等不良反应遥 有研究指出袁芬太尼在产妇镇痛效果上的个体差异性与细胞色 素P450 CYP3A4*1G的单核苷酸多态性渊SNP冤密切相关遥舒芬太尼和芬太尼同为CYP3A4*1G酶N-去烃基代谢 产物袁 所以袁CYP3A4*1G 的SNP也很有可能与舒芬太尼的量效个体差异性间存在着呼应关系遥 若能以 CYP3A4*1G单核苷酸分型为依据袁针对不同产妇个性化地应用舒芬太尼袁就有可能在提高麻醉镇痛效果的同 时袁降低用药剂量与副作用袁从而最终实现更好地保护新生儿与产妇健康的目的遥 本文结合近年来国内外已发 表的相关文献袁综合以上研究就细胞色素P450 CYP3A4*1G多态性对分娩镇痛舒芬太尼个体化用药的影响进 行综述遥 [关键词] CYP3A4*1G曰单核苷酸多态性曰分娩镇痛曰舒芬太尼曰个体化用药 [中图分类号] R614 [文献标识码]A [文章编号] 1673-7210渊2014冤06渊a冤-0166-03 Effects of the cytochrome P450 enzymes CYP3A4*1G single nucleotide polymorphisms on Sufentanilpersonalizedmedicine for labor analgesia ZHANG Qinglin Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University, Beijing 100026,China [Abstract]Atpresent, Sufentanilhasbecometherecommendedmedicineforlabor analgesia and ithasbeen moreand more used athome and abroad. However, a number of reports show that there are individual differences of Sulfentanyl when it was used in maternal with concentration and common dosage. It can cause the different incidence of side ef鄄 fects such as nausea, vomiting, fetal heart variability and uterine hyperfunction in different maternal. There is a study which find that single nucleotide polymorphism (SNP) of cytochrome P450 CYP3A4*1G is associatedwith individual differences of the fentanyls analgesic effect. Sufentanil and Fentanyl were both metabolised by CYP3A4*1G enzyme with N-dealkylation, sothere probably be a relationship between the SNP of CYP3A4*1G and Sufentanilsindividual diff