| 摘要: |
| ［摘要］ 目的 探讨μ阿片受体基因多态性对腰椎手术患者痛觉敏感性的影响，为指导个体化镇痛提供理论依据。方法 选择2018-08～2019-12新疆维吾尔自治区人民医院全麻下行腰椎手术患者218例。根据OPRM1 A118G基因型将其分为野生型纯合子组（AA组，85例）、突变型纯合子组(AG组，104例)和突变型杂合子组(GG组，29例)。采用MEB-5100型电刺激仪检测三组的痛阈、耐痛阈。比较三组术前的痛阈、耐痛阈，以及术后6 h、24 h、48 h静息时和活动时的数字评分量表(NRS)评分。结果 AA组痛阈、耐痛阈显著高于AG和GG组（P<0.05）；但AG组与GG组痛阈、耐痛阈比较差异无统计学意义（P>0.05）。同基因型男性患者的痛阈和耐痛阈均显著高于女性患者(P<0.05)。GG基因型中，≥50岁患者的痛阈、耐痛阈低于30～39岁和40～49岁患者(P<0.05)。AA基因型和AG基因型患者的痛阈、耐痛阈与年龄无显著关联(P>0.05)。三组静息时NRS评分在术后6 h、24 h、48 h时间点比较差异无统计学意义（P>0.05）。GG组在术后6 h、24 h、48 h时间点的活动时NRS评分均显著高于AA组和AG组（P<0.05），但AA组与AG组比较差异无统计学意义（P>0.05）。AA和AG组术后镇痛整体满意度显著高于GG组（P<0.05）。 结论 OPRM1 A118G基因多态性与机体的痛觉敏感度存在关联，并对腰椎手术患者的术后疼痛感造成影响。 |
| 关键词: μ阿片受体 术后疼痛 痛阈 耐痛阈 |
| DOI：10.3969/j.issn.1674-3806.2021.01.09 |
| 分类号:R 614 |
| 基金项目:新疆维吾尔自治区青年科学基金项目（编号：2017D01C144） |
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| Effect of μ-opioid receptor gene polymorphism on pain sensitivity in patients undergoing lumbar spine surgery |
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YANG Hui-hong, LA Hong-ling, CHEN Nan, et al.
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Medicine School, Shihezi University, Xinjiang 832000, China
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| Abstract: |
| ［Abstract］ Objective To explore the effect of μ-opioid receptor gene polymorphism on pain sensitivity in patients undergoing lumbar spine surgery, and provide a theoretical basis for guiding individualized analgesia. Methods Two hundred and eighteen patients undergoing lumbar spine surgery under general anesthesia in People′s Hospital of Xinjiang Uygur Autonomous Region from August 2018 to December 2019 were selected. According to OPRM1 A118G genotype, they were divided into wild-type homozygous group(AA group, n=85), mutant homozygous group(AG group, n=104) and mutant heterozygous group(GG group, n=29). The MEB-5100 electrical stimulator was used to detect the pain threshold and pain tolerance threshold of the three groups. The pain threshold and pain tolerance threshold were compared among the three groups before surgery, as well as the Numerical Rating Scale(NRS) scores at the time of rest and the time of activity 6 h, 24 h and 48 h after surgery. Results The pain threshold and pain tolerance threshold of the AA group were significantly higher than those of the AG group and the GG group(P<0.05). However, there were no significant differences in the pain threshold and pain tolerance threshold between the AG group and the GG group(P>0.05). The pain threshold and pain tolerance threshold of male patients with the same genotype were significantly higher than those of female patients with the same genotype(P<0.05). In patients with GG genotype, the pain threshold and pain tolerance threshold of patients aged ≥50 years were significantly lower than those of patients aged 30-39 and 40-49 years(P<0.05). There were no significant correlations between pain threshold, pain tolerance threshold and age in patients with AA genotype and AG genotype(P>0.05). There were no significant differences in NRS scores among the three groups at the time of rest at the time points of 6 h, 24 h and 48 h after surgery(P>0.05). The NRS scores of the GG group at 6 h, 24 h, and 48 h time points after surgery were significantly higher than those of the AA group and the AG group(P<0.05), but there were no significant differences between the AA group and the AG group(P>0.05). The overall satisfaction of postoperative analgesia in the AA group and the AG group was significantly higher than that in the GG group(P<0.05). Conclusion OPRM1 A118G gene polymorphism is associated with the body′s pain sensitivity and affects postoperative pain sensitivity in patients undergoing lumbar spine surgery. |
| Key words: μ-opioid receptor Postoperative pain Pain threshold Pain tolerance threshold |
