试点研究:内镜中的个性化医学,药物基因组学可以预测对有意识镇静的反应吗?
Himesh B Zaver1, Hassan Ghoz2, Balkishan Malviya2
1Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.
药物代谢酶的遗传变异会影响内镜期间的镇静需求. 降低CYP2C19,CYP3A5和UGT1A1代谢的患者通常需要正常的镇静水平.
科学领域:
- 药物基因组学 药物基因组学
- 胃肠病学 胃肠病学
- 麻醉学 麻醉学
背景情况:
- 对中度镇静的个体反应有很大差异.
- 药物代谢酶的遗传变异有助于这种变异性,影响药物的疗效和内镜手术期间的镇静需求.
研究的目的:
- 调查基因多态性在细胞染色体P450 (CYP450) 酶,特别是CYP3A4和CYP3A5中对镇静要求的作用.
- 评估药物代谢酶的遗传变异与在门诊内镜设置中的镇静需求之间的关联.
主要方法:
- 对106名接受门诊食道胃管腺镜 (EGD) 或结肠镜检查的患者进行了回顾性分析.
- 收集了关于镇静要求和药物基因组学的数据,将患者分类为高镇静组和正常镇静组.
主要成果:
- 降低CYP2C19代谢与需要正常镇静的可能性更高 (OR=0.38,p=0.03).
- 较差的CYP3A5代谢显著增加了需要正常镇静的可能性 (OR=0.25,p=0.0046).
- 较差的UGT1A1代谢表明,正常镇静的几率更高的趋势 (OR=2.76,p=0.08).
结论:
- 包括CYP2C19,CYP3A5和UGT1A1在内的CYP450酶的遗传变异与内镜手术中的镇静要求有关.
- 了解这些药物基因组差异可以帮助个性化门诊内镜的镇静策略.
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