文章摘要
CYP3A4*1G基因多态性对患者术后舒芬太尼用量和镇痛效果影响的Meta分析
Impact of CYP3A4*1G gene polymorphism on postoperative consumption of sufentanil and analgesic effect: a meta-analysis
  
DOI：10.12089/jca.2022.12.012
中文关键词: 细胞色素P450酶3A4  基因多态性  舒芬太尼  Meta分析
英文关键词: Cytochrome P450 3A4  Polymorphism  Sufentanil  Meta-analysis
基金项目:安徽省大学生创新创业项目（S202010368127X，S202110368076）；皖南医学院校中青年科研基金（WK202002，WK202009）
作者单位E-mail
徐启祥 241000,安徽省芜湖市,皖南医学院药学院  
程敏 241000,安徽省芜湖市,皖南医学院麻醉学院  
陈玉珍 241000,安徽省芜湖市,皖南医学院药学院  
王晓东 241000,安徽省芜湖市,皖南医学院麻醉学院  
张翠锋 241000,安徽省芜湖市,皖南医学院麻醉学院  
郭文俊 241000,安徽省芜湖市,皖南医学院麻醉学院 gwj8581@sina.com 
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中文摘要:
      
目的 评价细胞色素P450酶3A4*1G（CYP3A4*1G）的基因多态性对患者术后舒芬太尼用量及镇痛效果的影响。
方法 检索PubMed、Embase、Wiley Online Library、Cochrane Library、中国知网、维普、万方、中国生物医学文献数据库等数据库，收集由建库至2021年8月发表的关于CYP3A4*1G基因多态性对术后采用舒芬太尼镇痛影响的研究，按照Cochrane指导手册的方法选择文献、提取资料及评价研究质量，采用RevMan 5.4软件进行Meta分析。
结果 共纳入9篇文献，共计867例患者，其中CYP3A4*1G突变组351例，未突变组516例。Meta分析结果显示，与CYP3A4*1G突变组比较,未突变组术后24、48 h的舒芬太尼用量均明显增加（SMD=0.32，95%CI 0.19～0.46，P<0.001），术后24 h VAS疼痛评分明显升高（SMD=0.30，95%CI 0.13～0.47，P<0.001）。两组不良反应发生率差异无统计学意义。
结论 CYP3A4*1G基因多态性可明显减少患者术后舒芬太尼用量，降低术后24 h VAS疼痛评分，对术后不良反应无明显影响。
英文摘要:
      
Objective To assess the impact of cytochrome P450 3A4*1G(CYP3A4*1G) polymorphisms on postoperative consumption of sufentanil and analgesic effect by performing a meta-analysis.
Methods PubMed, Embase, Wiley Online Library, Cochrane Library, CNKI, VIP, Wanfang, CBM databases were searched. Literatures related to CYP3A4*1G gene polymorphism and postoperative use of sufentanil for analgesia were collected from the establishment of the database until August 2021. Then, the literatures were selected, data were extracted and studies quality were evaluated according to the Methods of the Cochrane guidance manual. RevMan 5.4 software was used for meta-analysis.
Results A total of 9 studies involving 867 patients revealed 351 patients in the CYP3A4*1G mutation group and 516 patients in the wild type group. The Results of meta-analysis showed that, compared with CYP3A4*1G mutation group, the dosage of sufentanil in wild type group was significantly increased 24, 48 hours after operation (SMD = 0.32, 95% CI 0.19-0.46, P < 0.001), and the VAS pain score was significantly increased 24 hours after operation (SMD = 0.30, 95% CI 0.13-0.47, P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups.
Conclusion The CYP3A4*1G polymorphisms can significantly reduce the dosage of sufentanil, reduce the VAS pain score 24 hours after operation, and has no obvious effect on postoperative adverse reactions.
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