發(fā)布時(shí)間：2018-01-19 10:43

  本文關(guān)鍵詞： 精準(zhǔn)醫(yī)療 圍手術(shù)期 β受體阻滯劑 阿片類藥物　出處：《臨床麻醉學(xué)雜志》2017年09期 　論文類型：期刊論文

【摘要】：隨著精準(zhǔn)醫(yī)療的不斷發(fā)展,醫(yī)師能夠根據(jù)患者的個(gè)體遺傳和分特征制定疾病的治療和預(yù)防策略。近年來,基因測序及其相關(guān)技術(shù)在醫(yī)療機(jī)構(gòu)中變得更加經(jīng)濟(jì)和便捷,其在各種醫(yī)療領(lǐng)域中的應(yīng)用范圍也在不斷擴(kuò)大。特別是在圍手術(shù)期,有很多使用精準(zhǔn)醫(yī)療的機(jī)會(huì)。例如,α和β腎上腺素能受體的個(gè)體多態(tài)性可提高β受體阻滯劑的療效,同時(shí)也使患者容易出現(xiàn)藥物不良反應(yīng),包括低血壓和心動(dòng)過緩等。同樣,阿片受體的個(gè)體多態(tài)性可以使阿片類藥物在術(shù)后鎮(zhèn)痛中的有效性提高或者降低。此外,細(xì)胞色素P450 2D6(CYP2D6)酶基因的突變可以通過加速或減緩β受體阻滯劑和阿片類藥物的代謝和清除,大大影響到二者的臨床反應(yīng)。術(shù)前基因測序可使麻醉醫(yī)師識(shí)別患者上述以及其他相關(guān)的分子特征,并相應(yīng)地選擇適當(dāng)?shù)膰中g(shù)期治療策略,從而最大限度地提高臨床療效,減少不良事件的發(fā)生率。當(dāng)下正是麻醉醫(yī)師和圍手術(shù)期醫(yī)務(wù)人員實(shí)踐精準(zhǔn)醫(yī)療的時(shí)候。
[Abstract]:With the continuous development of precision medicine, physicians can formulate the treatment and prevention strategy of disease according to the individual genetic and sub-characteristics of patients in recent years. Gene sequencing and related technologies have become more economical and convenient in medical institutions, and their applications in various medical fields are also expanding, especially in perioperative period. There are many opportunities to use accurate medicine. For example, individual polymorphisms of 偽 and 尾 adrenergic receptors can improve the efficacy of beta blockers and make patients vulnerable to adverse drug reactions. This includes hypotension and bradycardia. Similarly, individual polymorphisms of opioid receptors can increase or decrease the effectiveness of opioid drugs in postoperative analgesia. The mutation of cytochrome P450 2D6 (CYP2D6) enzyme gene can accelerate or slow down the metabolism and clearance of 尾 -receptor blockers and opiates. Gene sequencing before operation can enable anesthesiologists to identify these and other related molecular characteristics of patients and select appropriate perioperative treatment strategies accordingly. In order to maximize the clinical efficacy and reduce the incidence of adverse events, it is time for anesthesiologists and perioperative medical personnel to practice accurate medical treatment.
【作者單位】： Department
【分類號(hào)】：R614
【正文快照】： new　challenge:how　to　use　these　novel　technologies　toThe　Development　of　Precision　Medicineprovide　better　care　for　their　patients,to　improve　outcomes,The　Philadelphia　Chromosome　and　its　association　withand　to　maintain　cost-effect

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