目的 考察CYP2D6基因多態(tài)性對(duì)阿立哌唑治療兒童抽動(dòng)障礙的體內(nèi)藥物濃度和臨床療效的影響。方法 選取2021年1月—2022年5月就診于華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬武漢兒童醫(yī)院兒童保健科的抽動(dòng)障礙患兒作為研究對(duì)象，患兒上午口服阿立哌唑片，分別于治療前和治療第4、8周后觀(guān)察并記錄患兒的臨床療效和出現(xiàn)的不良反應(yīng)。治療達(dá)穩(wěn)態(tài)后采集血液樣本，檢測(cè)阿立哌唑、脫氫阿立哌唑血藥濃度和CYP2D6基因多態(tài)性。結(jié)果 超快代謝型、快速代謝型和中速代謝型3組之間阿立哌唑的C/D值、YGTSS減分率、有效率存在統(tǒng)計(jì)學(xué)差異（P＜0.05），不良反應(yīng)發(fā)生率無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)論 CYP2D6基因多態(tài)性能夠顯著影響阿立哌唑治療兒童抽動(dòng)障礙的血藥濃度和臨床療效，為實(shí)現(xiàn)個(gè)體化給藥提供參考

Objective To investigate the effect of CYP2D6 gene polymorphism on aripiprazole concentration and clinical efficacy in children with tic disorders treated with aripiprazole. Methods Children with tic disorders who were admitted to the Department of Child Health, Wuhan Children's Hospital, Tongji Medical College, from January 2021 to May 2022. Children were po administered with Aripiprazole Tablets in the morning, and the clinical efficacy and adverse reactions were observed and recorded before treatment and after 4 and 8 weeks of treatment. Blood samples were collected after reaching a stable state of treatment, and the serum concentrations of aripiprazole, dehydroariprazole, and CYP2D6 gene polymorphism were detected. Results There were statistically significant differences in the concentration/daily dosage per kilogram (C/D) value, YGTSS reduction rate, and effective rate of aripiprazole among ultra-rapid metabolizers groups, extensive metabolizers groups, and intermediated metabolizers groups (P < 0.05), while there was no statistically significant difference in the incidence of adverse reactions among three groups. Conclusion CYP2D6 gene polymorphism could significantly affect the serum concentration and clinical efficacy of aripiprazole in treatment of children with tic disorders, which could provide reference for clinical individualized medicine.

R971

國(guó)家重點(diǎn)研發(fā)計(jì)劃（2016YFC1306202）;湖北省科技計(jì)劃立項(xiàng)項(xiàng)目（2022DCC020）;武漢市醫(yī)學(xué)科研項(xiàng)目面上項(xiàng)目（WX21A14）