血药浓度和HTR1A基因检测对广西百色地区壮族精神分裂症患者喹硫平用药的指导价值分析
Study on the guiding value of blood concentration and HTR1A gene detection on quetiapine administration in Zhuang schizophrenia patients in Baise area of Guangxi
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| DOI |
| 刊名 |
Journal of International Psychiatry
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| 年，卷(期) |
2024, 51(2) |
| 作者 |
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| 作者单位 |
百色市第二人民医院检验科 ;
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| 摘要 |
摘要 目的：探讨广西百色地区壮族精神分裂症患者五羟色胺1A受体（5-hydroxytryptamine (serotonin) receptor 1A，HTR1A）基因表达情况和不同HTR1A基因表达患者接受喹硫平治疗后血药浓度情况，并分析血药浓度和HTR1A基因检测对喹硫平临床用药的指导价值。方法：择2022年1月-2023年1月来我院就诊的广西百色地区壮族精神分裂症患者86例，以荧光定量聚合酶链反应（Real-time fluorescent quantitative polymerase chain reaction，qRT-PCR）法对HTR1Ars6295基因型进行检测，所有患者均服用喹硫平进行治疗，治疗4w后，使用阳性和阴性症状量表（Positive and Negative Syndrome Scale，PANSS）评价效果，以液相色谱法对血药浓度检测，比较HTR1A基因不同表达患者疗效和血药浓度差异。结果：广西百色地区壮族精神分裂症患者HTR1A基因型及对应等位基因满足Hardy-weinberg平衡定律（P＜0.05），HTR1A CC型、CT型和TT型基因患者间血药浓度有统计学差异（P＜0.05），其中，TT型患者血药浓度较CT型和CC型患者高（P＜0.05），CT型和CC型患者血药浓度无统计学差异（P＞0.05），经4w治疗后HTR1A TT型患者阳性症状和总分减分值高于CC型和CT型（P＜0.05），一般精神病理征状和阴性症状减分值三组间差异无统计学意义（P＞0.05）。结论：不同HTR1A基因型广西百色地区壮族精神分裂症患者喹硫平血药浓度和PANSS评分减分值有一定差异，临床可依据不同基因分型患者血药浓度特点指导喹硫平用药剂量，从而在保证治疗效果的同时避免不良反应出现。
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| Abstract |
Abstract Objective: To investigate the expression of 5-hydroxytryptamine (serotonin receptor 1A, (HTR1A) gene in Zhuang schizophrenia patients in Baise area of Guangxi and the plasma concentration of different HTR1A gene expression patients after receiving quetiapine treatment, and to analyze the guiding value of serum concentration and HTR1A gene detection for clinical use of quetiapine. Method: A total of 86 patients with schizophrenia from Zhuang ethnic group in Baise area of Guangxi Province who came to our hospital from January 2022 to January 2023 were selected to detect the HTR1Ars6295 genotype of each patient by Real-time fluorescent quantitative polymerase chain reaction(qRT-PCR). All patients were treated with quetiapine. After 4 weeks of treatment, The therapeutic effect was evaluated by Positive and Negative Symptom Scale (PANSS), and the blood concentration was detected by liquid chromatography. The therapeutic effect and blood concentration difference of patients with different expression of HTR1A gene were compared. Result: The HTR1A genotype and corresponding alleles of Zhuang schizophrenia patients in Baise area of Guangxi met Hardy-weinberg balance law (P < 0.05), and there were statistical differences in blood drug concentration among CC, CT and TT gene patients of HTR1A (P < 0.05). The blood concentration of TT type patients was higher than CT type and CC type patients (P < 0.05), and there was no difference between CT type and CC type patients (P > 0.05). After 4w of treatment, the positive symptoms and total score reduction of HTR1A TT type patients were higher than CC type and CT type patients (P < 0.05). There was no difference in the reduction of general psychopathological signs and negative symptoms among the three groups (P > 0.05). Conclusion: Quetiapine serum concentration and PANSS score reduction in patients with schizophrenia in Baise area of Guangxi Province with different HTR1A genotypes have certain differences. Clinical dosages of quetiapine can be guided according to the characteristics of serum concentration in patients with different genotypes, so as to ensure the therapeutic effect and avoid adverse reactions.
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| 关键词 |
关键词：精神分裂症；血药浓度；HTR1A基因；喹硫平；用药指导
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| KeyWord |
Key words: schizophrenia; Blood drug concentration; HTR1A gene; Quetiapine; Medication guidance
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| 基金项目 |
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| 页码 |
390-393 |
谢可亮*.
血药浓度和HTR1A基因检测对广西百色地区壮族精神分裂症患者喹硫平用药的指导价值分析 [J].
国际精神病学杂志.
2024; 51; (2).
390 - 393.