本文選題：伊立替康 + UGTA基因多態(tài)性��； 參考：《中國(guó)藥房》2017年18期

【摘要】：目的:系統(tǒng)評(píng)價(jià)UGT1A1基因多態(tài)性與伊立替康致3~4級(jí)中性粒細(xì)胞減少不良反應(yīng)的相關(guān)性,為臨床提供循證參考。方法:計(jì)算機(jī)檢索中國(guó)期刊全文數(shù)據(jù)庫(kù)、萬(wàn)方數(shù)據(jù)庫(kù)、中文科技期刊數(shù)據(jù)庫(kù)、Pub Med、EMBase、Science direct與Cochrane圖書(shū)館,收集UGT1A1*28和UGT1A1*6基因多態(tài)性與伊立替康致3~4級(jí)中性粒細(xì)胞減少的相關(guān)研究,對(duì)符合納入標(biāo)準(zhǔn)的研究進(jìn)行提取資料和質(zhì)量評(píng)價(jià),采用Rev Man 5.3統(tǒng)計(jì)軟件進(jìn)行Meta分析。結(jié)果:共納入29項(xiàng)研究,合計(jì)2 408例患者。UGT1A1*28基因型分為野生型TA 6/6(UGT1A1*1/*1)和突變型TA 6/7(UGT1A1*1/*28)、TA 7/7(UGT1A1*28/*28),UGT1A1*6基因型分為野生型GG和突變型GA、AA。Meta分析結(jié)果顯示,UGT1A1*28和UGT1A1*6突變型患者3~4級(jí)中性粒細(xì)胞減少發(fā)生率顯著高于野生型,差異有統(tǒng)計(jì)學(xué)意義[UGT1A1*28:OR=1.92,95%CI(1.52,2.44),P0.001;UGT1A1*6:OR=2.49,95%CI(1.46,4.26),P0.001];伊立替康中、高劑量時(shí)UGT1A1*28和UGT1A1*6突變型患者3~4級(jí)中性粒細(xì)胞減少發(fā)生率顯著高于野生型,差異有統(tǒng)計(jì)學(xué)意義[UGT1A1*28:OR=2.06,95%CI(1.57,2.70),P0.001);UGT1A1*6:OR=1.92,95%CI(1.35,2.74),P0.001];而伊立替康低劑量時(shí)UGT1A1*28和UGT1A1*6突變型患者3~4級(jí)中性粒細(xì)胞減少發(fā)生率與野生型比較差異無(wú)統(tǒng)計(jì)學(xué)意義[UGT1A1*28:OR=1.20,95%CI(0.70,2.08),P=0.51;UGT1A1*6:OR=3.19,95%CI(0.85,11.89),P=0.08]。結(jié)論:伊立替康的中、高劑量使用時(shí),UGT1A1*28和UGT1A1*6突變基因會(huì)增加腫瘤患者重度中性粒細(xì)胞減少風(fēng)險(xiǎn);但在低劑量時(shí),基因多態(tài)性與中性粒細(xì)胞減少的相關(guān)性無(wú)明確的相關(guān)性。
[Abstract]:Objective: to evaluate the relationship between the polymorphism of UGT1A1 gene and the adverse reaction of neutrophilic granulocytopenia 3 grade 4 induced by irinotecan in order to provide evidence-based reference for clinical practice. Methods: the full text database of Chinese periodicals, Wanfang database, Chinese scientific journal database Pub MedEMBaseScience direct and Cochrane library were searched by computer. The correlation between UGT1A1*28 and UGT1A1*6 gene polymorphisms and 34 grade neutropenia induced by irinotecan was collected. The data were extracted and the quality was evaluated by using Rev Man 5.3 statistical software for Meta analysis. Results: a total of 29 studies were included, A total of 2 408 patients were divided into wild-type TA6 / 6 UGT1A1A1A1t1 / 1 / 1 and mutant TA6 / 7 UGT1A1A1A1 / 1 / 1 / 7 / 7 UGT1A1A1 / 7 / 7 / 7 UGT1A1 / 28 / UGT1A16 genotype. The results of meta-analysis showed that the incidence of neutropenia was significantly higher in UGT1A1A128 and UGT1A1*6 mutant patients than in wild-type GG and mutant GG and UGT1A1*6 mutant patients with 34 grades of neutrophilic granulocytopenia. The difference was statistically significant [UGT1A1 / 28: OR1: 1.92C95: CI1. 52 / 2.44 / P0.001 / UGT1A1 / 6: 2.49 / 95CI1.46 / 4.26 / P0.001], the incidence of grade 34 neutropenia in patients with UGT1A1*28 and UGT1A1*6 mutation at high doses was significantly higher than that in wild-type patients, and the rate of neutropenia was significantly higher in Iritecan patients than in wild-type patients. 宸紓鏈夌粺璁″鎰忎箟[UGT1A1*28:OR=2.06,95%CI(1.57,2.70),P0.001);UGT1A1*6:OR=1.92,95%CI(1.35,2.74),P0.001];鑰屼紛绔嬫浛搴蜂綆鍓傞噺鏃禪GT1A1*28鍜孶GT1A1*6紿佸彉鍨嬫?zhèn)ｈ�，

本文編號(hào)：1842554