本文選題：糖皮質(zhì)激素 + 股骨頭壞死��； 參考：《中國(guó)醫(yī)院藥學(xué)雜志》2016年09期

【摘要】：目的:系統(tǒng)評(píng)價(jià)患者長(zhǎng)期或大劑量應(yīng)用糖皮質(zhì)激素后發(fā)生股骨頭壞死與ABCB1C3435T、ABCB1G2677T/A基因多態(tài)性的關(guān)系,期望為其安全使用提供證據(jù)。方法:計(jì)算機(jī)檢索EMbase、PubMed、The Cochrane Library、Clinical Trials、CNKI、CBM、萬(wàn)方和維普數(shù)據(jù)庫(kù),查找關(guān)于激素性股骨頭壞死(SANFH)與ABCB1C3435T、ABCB1G2677T/A基因多態(tài)性的關(guān)系的觀察性研究和臨床試驗(yàn),檢索時(shí)限均從建庫(kù)截至2015年6月25號(hào)。對(duì)符合條件的研究,由2位研究者按照納入和排除標(biāo)準(zhǔn),獨(dú)立篩選文獻(xiàn)、提取資料、評(píng)價(jià)文獻(xiàn)質(zhì)量,并交叉核對(duì)后,采用Stata 12.0軟件進(jìn)行薈萃分析。結(jié)果:共納入8篇文獻(xiàn),包括8個(gè)研究(n=1 297);結(jié)果顯示應(yīng)用糖皮質(zhì)激素后,ABCB1C3435T攜帶者(CT或TT型)與野生型患者(CC型)的SANFH發(fā)生率存在統(tǒng)計(jì)學(xué)差異(P0.05);ABCB1G2677T/A則無(wú)統(tǒng)計(jì)學(xué)差異(P=0.15)。結(jié)論:對(duì)于長(zhǎng)期或大劑量應(yīng)用糖皮質(zhì)激素的患者,ABCB1(C3435T)T攜帶者發(fā)生SANFH的風(fēng)險(xiǎn)較低。因此,建議用藥前先檢測(cè)ABCB1C3435T基因型,再考慮是否單用糖皮質(zhì)激素或聯(lián)合雙膦酸鹽治療。
[Abstract]:Objective: to evaluate systematically the relationship between the necrosis of femoral head and ABCB1C3435T ABCB1G2677T / A gene polymorphism after long-term or high-dose glucocorticoid administration in order to provide evidence for its safe use. Methods: a computerized search for the Cochrane Library Clinical Trialsl CBM, Wannfang and Wiper databases was conducted to find out the relationship between SANFH and ABCB1C3435T / ABCB1G2677T / A gene polymorphism and clinical trials. The search time was from the establishment of the database to June 25, 2015. According to the criteria of inclusion and exclusion, the two researchers independently sifted the literature, extracted the data, evaluated the quality of the documents, and cross-checked, and then analyzed them by Stata 12.0 software. Results: a total of 8 articles were included, including 8 studies, and the results showed that the incidence of SANFH in ABCB1C3435T carriers (CT or TT) and wild-type patients (CC type) was significantly different from that in wild-type patients (P0.05, ABCB1G2677T / A), but there was no significant difference in SANFH incidence between ABCB1C3435T carriers and wild-type patients (P0.05G2677T / A). Conclusion: there is a lower risk of SANFH in ABCB1 C3435 T T carriers in patients with long term or high dose glucocorticoid use. Therefore, it is recommended that ABCB1C3435T genotypes be detected before medication and whether to use glucocorticoid or bisphosphonates alone.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院藥學(xué)部;
【基金】：河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃(編號(hào):201403019)
【分類(lèi)號(hào)】：R681.8
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本文編號(hào)：2024371