{"title":"COMT多态性Val158Met与术后疼痛患者阿片类药物消耗的关系:一项meta分析","authors":"Bo Hu, Xiaomin Zhang, Guangtao Xu, Qinmei Zhang, Ping Qian, Shengbing Liu, Jia Zhu, Ruilin Shen","doi":"10.1159/000487038","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>Several factors influencing postoperative pain and the effect of opioid analgesics have been investigated on an individual level. The aim of this study was to clarify the impact of catecholamine-O-methyltransferase (COMT) gene Val158Met on opioid consumption in postoperative patients.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of the literature up to September 30, 2017, were performed by using PubMed, Cochrane Library, ISI Web of Science, and Chinese National Knowledge Infrastructure (CNKI) database. The meta-analysis examined all studies involving the association between genetic polymorphisms of COMT Val158Met and opioid consumption during the acute postoperative period.</p><p><strong>Results: </strong>Of the 153 identified studies, 23 studies were retrieved for systematic review and 10 studies were retrieved for meta-analysis. However, it was impossible to conduct meta-analysis on the association between COMT Val158Met polymorphism and postoperative pain because of heterogeneity of the data. Overall, meta-analysis showed that COMT Val/Met carriers consumed less opioid for analgesia within the first 24 hours after surgery (SMD = 0.14, 95% CI = [0.03, 0.25], P = 0.01) but not within 48 hours (SMD = 0.14, 95% CI = [0.08, 0.36], P = 0.21). There was no significant difference in opioid consumption between Val/ Val and Met/Met patients.</p><p><strong>Conclusion: </strong>Patients with Val/Met but not Met/Met allele variant consumed less opioid, though larger and better-designed studies are required to obtain an exclusive conclusion about the correlation between postoperative pain and COMT Val158Met polymorphism.</p>","PeriodicalId":19171,"journal":{"name":"Neurosignals","volume":"26 1","pages":"11-21"},"PeriodicalIF":0.0000,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000487038","citationCount":"17","resultStr":"{\"title\":\"Association between COMT Polymorphism Val158Met and Opioid Consumption in Patients with Postoperative Pain: A Meta-Analysis.\",\"authors\":\"Bo Hu, Xiaomin Zhang, Guangtao Xu, Qinmei Zhang, Ping Qian, Shengbing Liu, Jia Zhu, Ruilin Shen\",\"doi\":\"10.1159/000487038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>Several factors influencing postoperative pain and the effect of opioid analgesics have been investigated on an individual level. The aim of this study was to clarify the impact of catecholamine-O-methyltransferase (COMT) gene Val158Met on opioid consumption in postoperative patients.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of the literature up to September 30, 2017, were performed by using PubMed, Cochrane Library, ISI Web of Science, and Chinese National Knowledge Infrastructure (CNKI) database. The meta-analysis examined all studies involving the association between genetic polymorphisms of COMT Val158Met and opioid consumption during the acute postoperative period.</p><p><strong>Results: </strong>Of the 153 identified studies, 23 studies were retrieved for systematic review and 10 studies were retrieved for meta-analysis. However, it was impossible to conduct meta-analysis on the association between COMT Val158Met polymorphism and postoperative pain because of heterogeneity of the data. Overall, meta-analysis showed that COMT Val/Met carriers consumed less opioid for analgesia within the first 24 hours after surgery (SMD = 0.14, 95% CI = [0.03, 0.25], P = 0.01) but not within 48 hours (SMD = 0.14, 95% CI = [0.08, 0.36], P = 0.21). There was no significant difference in opioid consumption between Val/ Val and Met/Met patients.</p><p><strong>Conclusion: </strong>Patients with Val/Met but not Met/Met allele variant consumed less opioid, though larger and better-designed studies are required to obtain an exclusive conclusion about the correlation between postoperative pain and COMT Val158Met polymorphism.</p>\",\"PeriodicalId\":19171,\"journal\":{\"name\":\"Neurosignals\",\"volume\":\"26 1\",\"pages\":\"11-21\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2018-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1159/000487038\",\"citationCount\":\"17\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurosignals\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000487038\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2018/1/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosignals","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000487038","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/1/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 17
摘要
背景/目的:在个体水平上研究了影响术后疼痛和阿片类镇痛药效果的几个因素。本研究的目的是阐明儿茶酚胺- o -甲基转移酶(COMT)基因Val158Met对术后患者阿片类药物消耗的影响。方法:采用PubMed、Cochrane Library、ISI Web of Science和中国知网数据库，对截至2017年9月30日的文献进行系统综述和meta分析。荟萃分析检查了所有涉及COMT Val158Met基因多态性与术后急性期阿片类药物消耗之间关系的研究。结果:在153项确定的研究中，23项研究被纳入系统评价，10项研究被纳入荟萃分析。然而，由于数据的异质性，无法对COMT Val158Met多态性与术后疼痛之间的关系进行meta分析。总体而言，荟萃分析显示，COMT Val/Met携带者在术后24小时内使用阿片类镇痛药物较少(SMD = 0.14, 95% CI = [0.03, 0.25]， P = 0.01)，但在48小时内使用阿片类镇痛药物较少(SMD = 0.14, 95% CI = [0.08, 0.36]， P = 0.21)。Val/ Val和Met/Met患者的阿片类药物消费无显著差异。结论:Val/Met而非Met/Met等位基因变异的患者消耗阿片类药物较少，但需要更大规模和更好设计的研究才能获得关于术后疼痛与COMT Val158Met多态性之间相关性的独家结论。
Association between COMT Polymorphism Val158Met and Opioid Consumption in Patients with Postoperative Pain: A Meta-Analysis.
Background/aims: Several factors influencing postoperative pain and the effect of opioid analgesics have been investigated on an individual level. The aim of this study was to clarify the impact of catecholamine-O-methyltransferase (COMT) gene Val158Met on opioid consumption in postoperative patients.
Methods: A systematic review and meta-analysis of the literature up to September 30, 2017, were performed by using PubMed, Cochrane Library, ISI Web of Science, and Chinese National Knowledge Infrastructure (CNKI) database. The meta-analysis examined all studies involving the association between genetic polymorphisms of COMT Val158Met and opioid consumption during the acute postoperative period.
Results: Of the 153 identified studies, 23 studies were retrieved for systematic review and 10 studies were retrieved for meta-analysis. However, it was impossible to conduct meta-analysis on the association between COMT Val158Met polymorphism and postoperative pain because of heterogeneity of the data. Overall, meta-analysis showed that COMT Val/Met carriers consumed less opioid for analgesia within the first 24 hours after surgery (SMD = 0.14, 95% CI = [0.03, 0.25], P = 0.01) but not within 48 hours (SMD = 0.14, 95% CI = [0.08, 0.36], P = 0.21). There was no significant difference in opioid consumption between Val/ Val and Met/Met patients.
Conclusion: Patients with Val/Met but not Met/Met allele variant consumed less opioid, though larger and better-designed studies are required to obtain an exclusive conclusion about the correlation between postoperative pain and COMT Val158Met polymorphism.
期刊介绍：
Neurosignals is an international journal dedicated to publishing original articles and reviews in the field of neuronal communication. Novel findings related to signaling molecules, channels and transporters, pathways and networks that are associated with development and function of the nervous system are welcome. The scope of the journal includes genetics, molecular biology, bioinformatics, (patho)physiology, (patho)biochemistry, pharmacology & toxicology, imaging and clinical neurology & psychiatry. Reported observations should significantly advance our understanding of neuronal signaling in health & disease and be presented in a format applicable to an interdisciplinary readership.
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