谷胱甘肽硫转移酶P1基因多态性与环磷酰胺不良反应关系的meta分析  

Relationship between glutathione S-transferase P1 gene polymorphism and adverse drug reactions induced by cyclophosphamide: a meta-analysis

作　　者：陈頔[1] 赵明[1] 梁良[1] 朱愿超[1] 杨莉萍[1] Chert Di;Zhao Ming;Liang Liang;Zhu Yuanchao;Yang Liping(Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Beijing 100730, China)

机构地区：[1]北京医院药学部/国家老年医学中心,100730

出　　处：《药物不良反应杂志》2018年第6期419-425,共7页Adverse Drug Reactions Journal

基　　金：国家卫生计生委保健局保健重点科研项目(W2016ZD01).

摘　　要：目的分析谷胱甘肽硫转移酶P(GSTP1)313A >G基因多态性与环磷酰胺(CP)不良反应的关系。方法检索国内外相关数据库(截至2017年7月),收集以GSTP1基因313A >G多态性与CP不良反应关系为主题的临床研究文献。依据STREGA标准对文献进行质量评价,采用RevMan5.2软件进行meta分析,效应指标为相对危险度(RR),及其95%置信区间(CI)。结果纳入meta分析的文献共7篇,质量评价结果均为可靠(评分均≥3分),共涉及1305例患者。meta分析结果显示,GSTP1基因313A >GAA基因型组与AG/GG基因型组患者采用CP联合其他化疗药物治疗后,白细胞减少、中性粒细胞减少、贫血、血小板减少、骨髓抑制和感染发生率的差异均无统计学意义(均P >0.05);AA基因型组患者胃肠道反应发生率低于AG/GG基因型组患者,差异有统计学意义(RR=0.46,95%CI:0.22~0.97,P=0.004);单用CP治疗的情况下,AA基因型组患者骨髓抑制发生率低于AG/GG基因型组患者,差异有统计学意义(RR=0.27,95%CI:0.08~0.91,P=0.03)。结论CP联合其他化疗药物所致胃肠道反应以及CP单药治疗所致骨髓抑制可能与GSTP1313A >G多态性有关。ObjectiveTo analyze the relationship between glutathione S-transferase P1(GSTP1)313A >G polymorphism and the adverse reactions induced by cyclophosphamide(CP).MethodsThe clinical research literature about the relationship between GSTP1 313A >G polymorphism and the adverse reactions induced by CP were collected from related domestic and foreign databases up to July,2017.The quality of the literature was evaluated by STREGA criterion.The meta-analysis was conducted by RevMan 5.2 software and the results were expressed as relative risk(RR)and 95% confidence interval(CI).ResultsA total of 7 articles were included in the meta-analysis and their quality evaluation results were reliable(all scores≥3),involving 1 305 patients.The results of meta-analysis showed that the differences of incidence of leukopenia,neutropenia,anemia,thrombocytopenia,myelosuppression,and infection after the treatments of CP combined with other chemotherapeutics between the patients with GSTP1 313A >G AA genotype and GSTP1 313A >G AG/GG genotype were not statistically significant(P >0.05 for all);the incidence of gastrointestinal reactions in patients with GSTP1 313A >G AA genotype was significantly lower than that in patients with GSTP1 313A >AG/GG genotype(RR=0.46,95%CI: 0.22-0.97,P=0.004);the incidence of myelosuppression after the treatment of CP alone in patients with GSTP1 313A >G AA genotype was significantly lower than that in patients with GSTP1 313A >G AG/GG genotype(RR=0.27,95%CI: 0.08-0.91,P=0.03).ConclusionThe gastrointestinal reactions induced by CP combined with other chemotherapeutics and myelosuppression induced by CP alone may be related to the polymorphism of GSTP1 313A >G.

关 键 词：谷胱甘肽转移酶 环磷酰胺 多态现象 遗传 META分析 

分 类 号：R969[医药卫生—药理学]