Abstract: ［Abstract］ Objective To investigate the analgesic effect of OPRM1 A118G gene polymorphism on sufentanil in patients with hilar cholangiocarcinoma. Method Fifty patients scheduled for elective hilar cholangiocarcinoma operation underwent combined intravenous and inhalationanesthesia. Patient-controlled analgesia（PCA） with sufentanil injection （2.00 μg·kg-1·h-1） was used for post-operative analgesia. The total dosage of sufentanil and adverse events were recorded at 24h and 48h after operation administration. The OPRM1 A118G gene type were detected. Results Among 55 patients， the proportion of AA，AG and GG genotype was 44%， 40% and 16%，respectively. Distribution frequency of A and G allele were 64% and 36%. The 24 h dosage of sufentanil in AG and GG genotype patients were both higher than AA genotype patients 60.02±21.45 μg vs 47.12±11.39 μg， P=0.040，77.93±31.87 μg vs 47.12±11.39 μg， P=0.031. At 48 h， the dosage of sufentanil in AG and GG genotype patients were also significantly higher than AA genotype patients103.92±27.66 μg vs 88.76±19.27 μg， P=0.009； 121.90±29.88 μg vs 88.76±19.27 μg， P=0.002）. There was no significant difference in adverse events between three groups （P>0.05）. Conclusion The analgesic efficacy of sufentanil was affected with OPRM1 A118G gene polymorphism in patients with hilar cholangiocarcinoma.

Key words: polymorphism, OPRM1 A118G, sufentanil

摘要： ［摘要］ 目的 探讨OPRM1 A118G基因多态性对肝门部胆管癌患者舒芬太尼术后镇痛效应的影响。方法 50例静吸复合全麻下行肝门部胆管癌患者，术后采用病人自控镇痛舒芬太尼注射液2 μg·kg-1·h-1。记录患者术后24 h、48 h的舒芬太尼用量及不良反应，并检测患者OPRM1 A118G基因型，评估不同基因型患者舒芬太尼的镇痛效应。结果 50例患者中，AA、AG及GG基因型比例分别为44%、40%及16%，A、G等位基因的频率分别为64%和36%。与AA基因型患者24 h、48 h的舒芬太尼用量47.12±11.39 μg，88.76±19.27 μg，相比，AG基因型患者均明显增加60.02±21.45 μg，103.92±27.66 μg，差异均有统计学意义（P<0.040，P<0.009），GG基因型患者分别为77.93±31.87 μg及121.90±29.88 μg，差异亦有统计学意义（P=0.031，P=0.002），恶心、呕吐及呼吸抑制发生率三组间无差异。结论 OPRM1 A118G基因多态性影响肝门部胆管癌患者对舒芬太尼的镇痛效果。

关键词: OPRM1 A118G, 舒芬太尼, 基因多态性