目的探讨CYP2D6*10等位基因及MDR1 C3435T基因多态性对浙南地区女性人群术后曲马多镇痛效果的影响.方法收集行子宫肌瘤剥除手术患者194例,手术结束前30 min肌肉注射曲马多,采用患者自控镇痛(PCA)模式进行术后镇痛.抽取外周血,采用聚合酶链反应-限制性条带长度多态性方法(PCR-RFLP),分析患者CYP2D6*10等位基因及MDR1 C3435T基因多态性,比较不同基因型患者之间曲马多的累积量,记录镇痛起效时间、持续时间、VAS及不良反应.结果 CYP2D6*10等位基因频率为52.84%,术后2、6、12h曲马多累积量及术后2、6hVAS的比较,m/m型明显高于w/w型和m/w型,差异有统计学意义(P<0.05).MDR1 C3435T等位基因频率为38.14%,3种不同基因型患者术后曲马多累积量及VAS的比较差异均无统计学意义(均P>0.05).结论在浙南地区女性人群中,CYP2D6*10等位基因对曲马多镇痛效果有显著影响,MDR1 C3435T等位基因对曲马多镇痛效果无显著影响.%Objective To investigate the association of CYP2D6*10 and MDR1 C3435T polymorphisms with analgesic ef-ficacy of tramadol in woman patients of Southern Zhejiang province. Methods One hundred and ninety four patients with hys-termyoma undergoing uterine myomatectomy from August 2010 to March 2012. Patients were given with loading dose of tramadol intramuscularly 30 minutes before the ending of surgery and received the postoperative patient-control ed analgesia (PCA). Samples of peripheral blood were col ected for DNA isolation. Polymorphisms of CYP2D6*10 and MDR1 C3435T were detected with PCR-RFLP analysis. The differences of tramadol consumption in the genotype groups were monitored and the starting time and duration of analgesia, VAS scores and adverse reaction were observed. Results The al elic frequency of CYP2D6 was 52.84%. The tramadol consumption at 2、6h and 12h after surgery and VAS at 2h and 6h after surgery in m/m type (n=50) were higher than those in w/w (n=39) and m/w (n=105) type (P<0.05). Variant al eles C3435T in MDR1 gene was seen in frequency of 38.14%. There were no significant differences in postoperative tramadol consumption and VAS among CC type (n=77), CT type (n=86) and TT type (n=31). Conclusion CYP2D6*10 is significantly associated with analgesic efficacy of tramadol in woman pa-tients of Southern Zhejiang province, while C3435T in MDR1 has no such association.
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