本文選題：CYP2D6　切入點：基因多態(tài)性　出處：《青島大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討CYP2D6基因檢測在兒童心律失常治療中的價值。方法:選取2014年12月31日-2016年12月31日就診于青島大學附屬醫(yī)院小兒內(nèi)科,確診為心律失常且需抗心律失常藥物治療的79名患兒為研究對象,隨機分為基因檢測組37例,基因未檢測組患兒42例。采用PCR-RFLP方法檢測37例心律失常患兒CYP2D6*10基因型,根據(jù)其結(jié)果調(diào)整藥物劑量。收集患兒一般情況、病因、心律失常類型、抗心律失常藥物總量、抗心律失常藥物平均劑量、治療時間等,分析治療效果、副總用發(fā)生率。結(jié)果:基因檢測組患兒最常見的CYP2D6*10基因型為突變雜合子,其次為突變純合子,野生型純合子最少,未見多拷貝的野生型純合子,整體基因突變率72.97%。相應地,CYP2D6酶表型,最多見為中強代謝型,其次為弱代謝型,強代謝型少見,未見超強代謝型�；驒z測組及基因未檢測組患兒在性別、年齡、病因、心律失常類型、抗心律失常藥物種類及治療前心臟超聲、心電圖、肝腎功能、血白細胞方面及副作用發(fā)生率方面無統(tǒng)計學差異(P0.05)�；驒z測組患兒抗心律失常藥物總量、平均劑量小于基因未檢測組(P0.05),抗心律失常藥物用藥時間短于基因未檢測組,但無明顯統(tǒng)計學差異(P0.05)。結(jié)論:CYP2D6*10最常見基因型為突變雜合子,酶活性以中強代謝型為主,酶活性影響部分抗心律失常藥物的代謝。CYP2D6基因檢測在兒童心律失常治療中指導個體化用藥、預測有效率、減少或避免不良反應的發(fā)生上具有重要的價值。CYP2D6基因型對預測藥物有效率、治療療程方面有一定的價值。
[Abstract]:Objective: to evaluate the value of CYP2D6 gene detection in the treatment of arrhythmia in children. 79 children who were diagnosed as arrhythmia and needed antiarrhythmic drugs were randomly divided into gene detection group (n = 37) and gene undetected group (n = 42). CYP2D6*10 genotypes were detected by PCR-RFLP method in 37 patients with arrhythmia. According to the results, the drug dosage was adjusted. The general situation, etiology, type of arrhythmia, total amount of antiarrhythmic drugs, average dose of antiarrhythmic drugs, treatment time, etc., were collected to analyze the therapeutic effect. Results: mutation heterozygote was the most common CYP2D6*10 genotype, followed by mutant homozygote, wild type homozygote was the least, and no multiple copies of wild type homozygote were found in the gene detection group. The overall mutation rate of CYP2D6 was 72.97.The phenotype of CYP2D6 was the most common, followed by weak metabolic type, strong metabolic type was rare, and no hypermetabolic type was found. There was no significant difference in arrhythmia type, antiarrhythmic drugs, heart ultrasound, ECG, liver and kidney function, blood leukocyte and side effects before treatment (P 0.05). The total amount of antiarrhythmic drugs in gene detection group was higher than that in control group (P < 0. 05). The average dose was less than that in the undetected gene group (P 0.05), and the antiarrhythmic drug use time was shorter than that in the gene undetected group, but there was no significant difference between the two groups (P 0.05). Conclusion the most common genotype of CYP2D6 / 10 is mutant heterozygote, and the enzyme activity is mainly of medium and strong metabolic type. Enzyme activity affects metabolism of some antiarrhythmic drugs. CYP2D6 gene detection can guide individualized drug use in the treatment of arrhythmia in children and predict the effective rate. It has important value to reduce or avoid adverse reactions. CYP2D6 genotype can predict the effective rate of drugs and has certain value in treatment course.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.4

【參考文獻】

相關期刊論文 前10條

1 王艷;高飛;哈斯蘇榮;;應用特異性探針藥物分析雙峰駝CYP2D6酶體外活性[J];畜牧獸醫(yī)學報;2016年12期

2 李居怡;王健;王奕;甘利明;黃文靜;鄧艾平;;他汀類藥物降脂治療的CYP2D6基因多態(tài)性及其與高脂血癥的關系[J];實用醫(yī)學雜志;2016年02期

3 韋龍靜;姚志劍;;CYP2D6基因多態(tài)性與文拉法辛抗抑郁治療效應的關聯(lián)研究進展[J];中華精神科雜志;2015年02期

4 董天崴;王爽;楊軍;張志國;;CYP2D6基因多態(tài)性與藥物基因組學研究的進展[J];心血管康復醫(yī)學雜志;2014年03期

5 李小梅;;兒童心律失�！沃氐肋h[J];中華心律失常學雜志;2014年01期

6 楊曉東;;兒童心律失常的臨床診斷和治療[J];中華臨床醫(yī)師雜志(電子版);2012年24期

7 徐艷嬌;龔森;紀洪艷;劉東;;CYP2D6基因多態(tài)性及其臨床意義[J];醫(yī)藥導報;2012年10期

8 徐田雪;楊信怡;趙昆;張喜川;游雪甫;;藥物代謝酶細胞色素P450 2D6的遺傳多態(tài)性研究進展[J];中國抗生素雜志;2009年07期

9 楊勇;王友群;;CYP2D6遺傳多態(tài)性對臨床個體化給藥的影響[J];世界臨床藥物;2006年01期

10 李倩;朱大嶺;;細胞色素P450 2D6遺傳多態(tài)性的研究進展[J];醫(yī)學研究通訊;2005年02期

，

本文編號：1639906