CYP2C19*17基因对氯吡格雷临床疗效影响的Meta分析  

Impact of CYP2C19*17 Gene Polymorphisms on Clinical Efficacy of Clopidogrel:A Meta-analysis

作　　者：谢婧[1,2] 杨莉萍[2] 刘瑶[2] 胡欣[2] 

机构地区：[1]沈阳药科大学药学院,沈阳110016 [2]卫生部北京医院药学部,北京100730

出　　处：《中国药房》2012年第28期2618-2621,共4页China Pharmacy

基　　金：卫生部科技教育司卫生行业科研专项课题(201002011)

摘　　要：目的:系统评价CYP2C19*17基因对氯吡格雷临床疗效的影响。方法:分别对EMBase、PubMed、Cochrane图书馆、中国生物医学文献数据库(CBM)以及中国期刊网数据库(CNKI)等进行文献检索,用ReviewsManager5.1系统进行数据分析。结果:共纳入5篇文献,包含6项研究,合计29499例患者。Meta分析结果显示,CYP2C19*17携带者在使用氯吡格雷后,心血管事件发生率显著低于非携带者[RR=0.82,95%CI(0.73,0.93),P=0.001];出血事件发生率高于非携带者[RR=1.20,95%CI(1.01,1.42),P=0.03]。结论:在使用氯吡格雷的心血管疾病患者中,与CYP2C19*17非携带者比较,心血管事件发生率在CYP2C19*17携带者中较低,而出血性事件的发生率则较高。因此,CYP2C19*17携带者在使用氯吡格雷时应谨防出血性事件的发生,基因检测有助于完善个体化合理用药。OBJECTIVE:To evaluate the impact of CYP2C19*17 gene polymorphisms on the clinical efficacy of clopidogrel systematically.METHODS:The literature was searched from the following electronic databases:EMBase,PubMed,Cochrane Library,CBM and CNKI.A meta-analysis was performed with Cochrane Collaboration's Review Manager 5.1.RESULTS:A total of 5 literatures,including 6 studies(n=29 499),were included according to inclusive criteria and exclusion criteria.The Meta-analysis showed that:the incidence of cardiovascular events in CYP2C19*17 alleles carriers was significantly lower than non-carriers[RR=0.82,95%CI(0.73,0.93),P=0.001];however,the incidence of bleeding events in CYP2C19*17 alleles carriers was higher than non-carriers [RR=1.20,95%CI(1.01,1.42),P=0.03].CONCLUSION:After the treatment of clopidogrel,the recurrence rate of cardiovascular events in CYP2C19*17 alleles carriers is lower than non-carriers,while the incidence of bleeding events is higher than non-carriers.In conclusion,CYP2C19*17 allele carriers should be aware of bleeding events when using clopidogrel.Genetic testing contributes to the improvement of individual rational drug use.

关 键 词：氯吡格雷 基因多态性 CYP2C19＊17 META分析 

分 类 号：R964[医药卫生—药理学]