围手术期精准医疗有助于麻醉医师改善患者预后:β受体阻滞剂与阿片类药物的遗传变异性（英文）

发布时间：2018-01-19 10:43

本文关键词： 精准医疗围手术期 β受体阻滞剂阿片类药物　出处：《临床麻醉学杂志》2017年09期 　论文类型：期刊论文

【摘要】：随着精准医疗的不断发展,医师能够根据患者的个体遗传和分特征制定疾病的治疗和预防策略。近年来,基因测序及其相关技术在医疗机构中变得更加经济和便捷,其在各种医疗领域中的应用范围也在不断扩大。特别是在围手术期,有很多使用精准医疗的机会。例如,α和β肾上腺素能受体的个体多态性可提高β受体阻滞剂的疗效,同时也使患者容易出现药物不良反应,包括低血压和心动过缓等。同样,阿片受体的个体多态性可以使阿片类药物在术后镇痛中的有效性提高或者降低。此外,细胞色素P450 2D6(CYP2D6)酶基因的突变可以通过加速或减缓β受体阻滞剂和阿片类药物的代谢和清除,大大影响到二者的临床反应。术前基因测序可使麻醉医师识别患者上述以及其他相关的分子特征,并相应地选择适当的围手术期治疗策略,从而最大限度地提高临床疗效,减少不良事件的发生率。当下正是麻醉医师和围手术期医务人员实践精准医疗的时候。
[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 伪 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.
【作者单位】： Department
【分类号】：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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