| Objectives:To explore the correlation between MDR1G1199A,ABCB1G2677T/A,UGT1A6A552C,T19G and UGT2B7C161T gene polymorphisms and the plasma concentration of sodium valproate in patients with epilepsy,and provide a basis for individualized treatment of patients with epilepsy.Methods:A total of 100 confirmed epilepsy patients treated with sodium valproate monotherapy were selected from May 2019 to October 2020 in the outpatient and inpatient clinics of a tertiary hospital in Kunming.Chemiluminescence(CMIA)was used to monitor the steady-state plasma concentration of sodium valproate,and polymerase chain reaction(PCR)was used to genotype MDR1G1199A,ABCB1G2677T/A,UGT1A6A552C,T19G and UGT2B7C161T.SPSS17.0 statistical software was used for data statistical analysis.Results:1.In this study,100 subjects were included.No MDR1G1199A locus mutation gene carriers were detected.The genotype frequencies of the remaining 4 SNPs were in accordance with the Hardy-Weinberg balance(P>0.05);The G allele frequency of ABCB1G2677T/A locus was 42.5%,T allele frequency was 43.5%,A allele frequency was 14%;UGT1A6A552C locus A allele frequency was 70.5%,C allele frequency was 29.5%;UGT1A6T19G locus T allele frequency was 74.5%,the G allele frequency was 25.5%;UGT2AB7C161T locus C allele frequency was 64%,and the T allele frequency was 36%.2.The UGT1A6T19G gene polymorphism was significantly correlated with the standardized plasma concentration of sodium valproate in patients with epilepsy(P<0.05).The standardized plasma concentration of sodium valproate in patients with TT,TG,and GG genotypes was(4.33±1.97)μg.kg/ml.mg,(3.40±1.61)μg.kg/ml.mg,(2.91±1.94)μg.kg/ml.mg,respectively,Mutant allele carriers(TG+GG)of valproate standardized plasma concentration was significantly lower than wild homozygous type(TT),statistically significant difference(P<0.05),in which the mutation homozygous type(GG)in patients with valproate standardized plasma concentration was significantly lower than mutations in patients with type hybrid(TG)and wild homozygous type(TT),The difference was statistically significant(P<0.05).there was no significant difference in the standardized plasma concentration levels of sodium valproate in patients with different genotypes of ABCB1G2677T/A,UGT1A6A552C,and UGT2B7C161T(P>0.05).3.Among the 100 subjects included in this study,the dosage form was significantly correlated with the compliance rate of plasma concentration of sodium valproate(P<0.05).The compliance rate of plasma concentration of patients taking sodium valproate sustained release agent was higher than that of sodium valproate non-sustained release agent,but there was no significant correlation with gender and age(P>0.05).In addition,there were significant differences in the standardized plasma concentration of sodium valproate among patients of different age groups(P<0.05),and the standardized plasma concentration of sodium valproate in patients under 18 years old group was significantly lower than that in patients of 18～39 years old group,40～59 years old group and 60 or more years old group(P<0.05).There was no statistical difference in the standardized plasma concentration of sodium valproate among the other 3 age groups(P>0.05).Conclusions:1.This study did not find mutations in MDR1G1199A in patients with epilepsy.Combined with previous research reports,it can be speculated that MDR1G1199A has a low mutation rate in the Chinese Han population and will not be discussed in future studies.2.UGT1A6T19G gene polymorphism can significantly affect the plasma concentration of sodium valproate in patients with epilepsy.The plasma concentration of sodium valproate in G allele carriers is significantly lower than that in wild homozygous(TT)patients,and homozygous mutant GG genotype The patient’s sodium valproate plasma concentration decreased significantly.3.The influence of ABCB1G2677T/A,UGT1A6A552C and UGT2B7C161T gene polymorphisms on the plasma concentration of sodium valproate in patients with epilepsy was not statistically significant. |
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