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目的:探讨儿茶酚氧位甲基转移酶(COMT)基因功能多态性对帕罗西汀治疗2型糖尿病合并抑郁焦虑患者的疗效的影响。方法:对52例血糖控制不理想的2型糖尿病合并抑郁焦虑患者,治疗前抽取外周静脉血,提取DNA,用PCI技术检测研究对象的基因型,分成Val/Val、Val/Met和Met/Met 3组,在常规降糖治疗基础上加用帕罗西汀每晨一次,每次20 mg,疗程4周,观察治疗前、后汉密尔顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)分数、餐后2 h血糖(2hPBG)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、帕罗西汀血药浓度的改变。结果:治疗后不同基因组患者抑郁情绪有改善,HAMD、HAMA、2hPBG、FBG、HbA1c、血药浓度与治疗前比较均有显著性差异(P<0.01),但4周后3基因组间差异并无显著性(P>0.05)。结论:对2型糖尿病合并抑郁焦虑患者,加用帕罗西汀治疗能有效改善抑郁症状及更好地控制血糖,COMT基因功能多态性与帕罗西汀疗效差异可能并不相关。
Objective: To investigate the effect of COMT gene polymorphism on paroxetine in the treatment of type 2 diabetes mellitus patients with depression and anxiety. Methods: 52 patients with type 2 diabetes mellitus with depression and anxiety who did not control glycemic control were enrolled in this study. Peripheral venous blood was drawn before treatment and DNA was extracted. The genotypes of the subjects were determined by PCI, and divided into Val / Val, Val / Met and Met / Met 3 groups were treated with paroxetine once a day for 20 mg every morning for 4 weeks. The HAMD, , Postprandial 2h blood glucose (2hPBG), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), paroxetine plasma concentration changes. Results: After treatment, the depression of patients with different genotypes was improved. The levels of HAMD, HAMA, 2hPBG, FBG, HbA1c and plasma concentration were significantly different from those before treatment (P <0.01) Significance (P> 0.05). CONCLUSIONS: Patients with type 2 diabetes mellitus and depression and anxiety, plus paroxetine treatment, can effectively improve depression symptoms and better control blood glucose. The functional polymorphism of COMT gene may not be related to the difference in efficacy of paroxetine.