目的：阿片类药物引起的药物不良反应（ADR）存在个体差异。我们的目的是探讨基因多态性与阿片类药物引起的ADR之间的关系。
方法：对阿片类药物诱导的ADR相关基因进行循证医学数据分析，筛选靶基因。60名服用阿片类药物后出现不良反应的癌症疼痛患者（吗啡，可待因,羟考酮)和60例服用阿片类药物后无不良反应的患者作为实验组和对照组,分别。然后，我们使用聚合酶链反应（PCR）或原位杂交来检测靶基因。通过结合年龄等临床数据，性别,药物的剂量和持续时间，统计分析基因多态性对患者服用阿片类药物后不良反应的影响。
结果：基于数据库搜索和循证医学数据，我们确定CYP2D6*10,CYP3A5*3,ABCB1和OPRM1为检测的靶基因.统计学分析结果显示,实验组与对照组基因型分布差异无统计学意义(p>0.05)。然而,如果选择32名服用羟考酮后出现不良反应的患者和32名对照进行比较，SPSS22.0和SNPStats遗传模型显示ABCB1(062rs1045642)CT和TT基因型与ADR发生相关(p<0.05):实验组CT+TT基因型总数为29个(90.62%),对照组有11种(34.37%)CT+TT基因型。
结论：ABCB1（062rs1045642）的多态性与羟考酮引起的不良反应有关，等位基因T的ADR发生率较高。ABCB1的多态性有望成为羟考酮ADR的临床预测因子，并应注意ABCB1(062rs1045642)CT和TT基因型患者严重ADR的发生。
Adverse drug reactions (ADRs) caused by opioid drugs show individual differences. Our objective was to explore the association between gene polymorphism and ADRs induced by opioid drugs.
Evidence-based medical data analysis was conducted for genes related to ADRs induced by opioid drugs to select target genes. Sixty patients with cancer pain who had ADRs after taking opioid drugs (morphine, codeine, oxycodone) and 60 patients without ADRs after taking opioid drugs were used as the experimental group and control group, respectively. Then, we used polymerase chain reaction (PCR) or in situ hybridization to detect target genes. By combining with clinical data such as age, sex, dosage and duration of medication, the effect of gene polymorphism on the ADR of patients after taking opioid drugs was statistically analysed.
Based on a database search and evidence-based medical data, we identified CYP2D6*10, CYP3A5*3, ABCB1, and OPRM1 as target genes for detection. The results of statistical analysis showed no significant difference in genotype distribution between the experimental group and the control group (p > 0.05). However, if 32 patients with ADRs after taking oxycodone and 32 controls were selected for comparison, the SPSS22.0 and SNPStats genetic models showed that the ABCB1 (062rs1045642) CT and TT genotypes correlated with the occurrence of ADRs (p < 0.05): the total number of CT + TT genotypes in the experimental group was 29 (90.62%), with 11 (34.37%) CT + TT genotypes types in the control group.
Polymorphism of ABCB1 (062rs1045642) is related to ADRs caused by oxycodone, and the incidence of ADRs is higher with the allele T. Polymorphism of ABCB1 is expected to become a clinical predictor of ADRs to oxycodone, and attention should be given to the occurrence of serious ADRs in patients with ABCB1 (062rs1045642) CT and TT genotypes.
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