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目的 探讨抗精神病药物 (APS)所致体重增加与多巴胺D2 受体 (DRD2 )基因TaqIA多态性和治疗效应之间有无相关。方法 采用PCR RFLP方法分析 117例首发精神分裂症患者DRD2 基因TaqIA多态性 ,APS(氯丙嗪或利培酮 )单药治疗 10周 ,测定患者治疗前后体重和体重指数 (BMI) ,用阳性和阴性症状量表 (PANSS)评定患者治疗前后精神症状 ,并分析BMI变化值与基因型和PANSS减分率的相关性。结果 治疗后患者平均体重变化 (3 15± 3 47)kg或基础体重的(5 6 9± 6 15 ) % ,体重变化的范围为 - 7kg～ 12kg或 - 7 78%～ 32 43% ;患者年龄和基础BMI明显影响BMI变化值 ,差异有显著性 (P =0 0 3)和非常显著性 (P =0 0 0 0 1) ;A1等位基因和PANSS减分率对BMI变化值的影响差异均无显著性 (P >0 0 5 )。结论 DRD2 基因TaqIA多态性不可能是APS所致精神分裂症体重增加的主要遗传因素 ;体重增加不是APS临床治疗效果的指标。
Objective To investigate the relationship between antipsychotics (APS) -induced weight gain and the TaqIA polymorphism of dopamine D2 receptor (DRD2) gene and its therapeutic effect. Methods A total of 117 patients with first-episode schizophrenia were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for DRD2 gene TaqIA polymorphism. APS (chlorpromazine or risperidone) monotherapy for 10 weeks was used to measure the body mass and body mass index (BMI) And negative symptom scale (PANSS) were used to assess the psychiatric symptoms before and after treatment. The correlation between BMI and genotype and PANSS reduction rate was analyzed. Results The average weight change (3 15 ± 3 47) kg or basal body weight (569 ± 6 15)% and body weight ranged from -7 kg to 12 kg or -7 78% to 32 43% after treatment. The patients’ age And basal BMI significantly affected the BMI changes, the difference was significant (P = 0 0 3) and very significant (P = 0 0 0 0 1); Al alleles and PANSS reduction rate of BMI changes in the value of the difference No significant (P> 0.05). Conclusion It is impossible that the TaqIA polymorphism of DRD2 gene is the major genetic factor of weight gain in schizophrenia induced by APS. Weight gain is not an indicator of the clinical efficacy of APS.