精神分裂症90例基因检测回顾性分析

摘要

目的 从临床应用情况回顾性分析实施抗精神病药物相关的细胞色素P450(CYP450)酶基因多态性检测对住院精神分裂症患者治疗方案的影响及意义.方法 采用真实世界研究(RWS)对所有患者进行真实状态下观察并记录,根据基因检测结果将等位基因突变患者划归为等位基因突变组(42例),将正常代谢型患者划归为正常代谢组(48例).于入院时及出院时采用阳性和阴性综合征量表(PANSS)总分评价两组疗效.于住院1周时、出院时采用治疗中需处理的不良反应症状量表(TESS)评定不良反应.比较两组基因检测后更改方案发生率.结果 90例患者中检出06CYP2D6* 10为42例,余48例均为正常代谢型,故06CYP2D6* 10突变率为46.7％.两组基因检测后更改方案发生率比较差异有统计学意义(P＜0.01).两组出院时PANSS量表总分均较各自入院时降低(P＜0.05).等位基因突变组住院1周时不良反应发生率高于正常代谢组(P＜0.01).出院时两组有效率及不良反应发生率比较差异无统计学意义(P＞0.05).结论 对住院精神分裂症患者实施基因检测可以有效辅助治疗方案调整,值得临床推广.%Objective To explore the effects of polymorphisms detecting in cytochrome P450 (CYP450) enzymes relative to antipsychotics on treatment plan in schizophrenic inpatients.Methods All patients,observed and recorded in real state using real-world studies,were divided into allelic mutation group (n =42) and normal metabolism group (n =48) according to the genetic test results.They were assessed with Positive and Negative Syndrome Scale (PANSS),Treatment Emergent Symptoms Scale(TESS).The incidence rates of treatment plan changes in both groups were compared.Results 42 patients with 06CYP2D6* 10 were detected from 90 patients,and the remaining 48 cases were normal metabolic type;mutation rate of 06CYP2D6 * 10 was 46.7％.It was significantly different for both groups in the treatment plan changes after the genetic test(P ＜0.01).When discharged,the total scores of PANSS in both groups decreased significantly compared with those on admission (P ＜ 0.05).The incidence rate of adverse reactions in allelic mutation group was significantly higher than that in normal metabolism group after 1 week of admission(P ＜0.01).There was no significant difference in effective rates and incidence rates of adverse reactions between both groups when discharged (P ＞ 0.05).Conclusion The implementation of genetic test for schizophrenic inpatients can effectively assist the treatment system,which is worthy of promotion.