COMT基因多态性和抗精神分裂症药物疗效关系的Meta分析  

COMT genetic variation and clinical response to antipsychotic drug treatment: A Meta-analysis

作　　者：陈卉[1] 涂娇[1] 倪平[1] 张伟[2] 许林勇[1,3] 

机构地区：[1]中南大学公共卫生学院卫生统计学教研室,长沙410078 [2]中南大学湘雅医院临床药理研究所,长沙410008 [3]中南大学湘雅三医院药物临床研究统计分析中心,长沙410013

出　　处：《中南大学学报（医学版）》2015年第6期623-631,共9页Journal of Central South University ：Medical Science

基　　金：国家"重大新药创制"科技重大专项(2012ZX09303014-001);湖南省自然科学基金(13JJ5017)~~

摘　　要：目的:探讨儿茶酚胺氧位甲基转移酶(catechol O-methyltransferase,COMT)Val108/158 Met基因多态性与抗精神分裂症药物疗效之间的关系,为抗精神分裂症药物的个体化用药提供一定的依据。方法:计算机检索Pub Med,Embase,Cochrane Library,中国知网,万方,维普,中国生物医学文献数据库获取相关文献。在评价原始研究质量,提取有效数据后,采用Stata12.0进行统计分析。结果:共筛选出9篇符合标准的文献,包含868例患者。Meta分析结果显示各基因型合并后的RR值、95%CI及P值,以患者的总体症状改善情况来评价药物疗效时,Met与Val比较,RR=1.18,95%CI:1.04~1.35,P=0.013;Met/Met与Val/Val比较,RR=1.40,95%CI:1.08~1.82,P=0.010。以患者的阴性症状改善情况来评价药物疗效时,Met与Val比较,RR=1.24,95%CI:1.05~1.46,P=0.013;Met/Met与Val/Val比较,RR=1.60,95%CI:1.04~2.46,P=0.031。结论:COMT Val108/158Met基因多态性与抗精神分裂症药物疗效显著相关,其中Met基因为优势基因,对抗精神分裂症药物反应较好。Objective: To examine the relationship between COMT polymorphisms and the response to antipsychotic drugs, and then provide a basis for personalized medicine of antipsychotic drugs. Methods: We performed a systematic search from Pub Med, Embase, Cochrane Library, CBM, CNKI, VIP and Wanfang database for eligible studies. Stata 12.0 was used for Meta-analysis aft er evaluating the quality of studies and collecting the data. Results: Nine studies included 868 participants met inclusion criteria. Significant association was found between the COMT Val108/158 Met gene polymorphism and antipsychotic drug efficacy. Evaluating the therapeutic efficacy through general symptoms: Met vs Val, RR=1.18, 95% CI: 1.04-1.35, P=0.013; Met/Met vs Val/Val, RR=1.40, 95% CI: 1.08-1.82, P=0.010. Evaluating the therapeutic efficacy through negative symptoms: Met vs Val, RR=1.24, 95% CI: 1.05-1.46, P=0.013; Met/Met vs Val/Val, RR=1.60, 95% CI: 1.04-2.46, P=0.031. Conclusion: COMT Val108/158 Met gene polymorphism is significantly associated with antipsychotic drug efficacy, and Met gene is a dominant gene which displays a better response to antipsychotic drugs.

关 键 词：儿茶酚胺氧位甲基转移酶 精神分裂症 基因多态性 META分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]