DPYD*2A、c.2846A>T和*13基因多态性与氟尿嘧啶类药物毒性反应相关性的Meta分析  

Correlation between the DPYD*2A,c.2846A>T and *13 gene polymorphism and fluorouracil-related toxicity:a Meta analysis

作　　者：张爱玲[1] 杨晶[1] 朱振峰[1] 鲁憬莉[1] 张晓坚[1] 

机构地区：[1]郑州大学第一附属医院药学部,河南郑州450052

出　　处：《中国医院药学杂志》2017年第1期52-57,61,共7页Chinese Journal of Hospital Pharmacy

基　　金：常州四药临床药学科研基金(编号:CZSYJJ15002)

摘　　要：目的:系统评价患者采用氟尿嘧啶类药物为基础化疗方案时出现3级以上的毒性反应与DPYD*2A、c.2846A>T和*13基因多态性的关系,期望为其个体化用药提供证据。方法:计算机检索EMbase、PubMed、The Cochrane Library、Clinical Trials、CNKI、CBM、万方和维普数据库,查找关于氟尿嘧啶类药物的毒性与DPYD*2A、c.2846A>T和*13基因多态性的关系的临床研究,检索时限均从建库截至2016年1月18日。对符合条件的研究,由2位研究者按照纳入和排除标准,独立筛选文献、提取资料、评价文献质量,并交叉核对后,采用RevMan 5.2和Stata 12.0软件进行Meta分析。结果:共纳入19篇文献,包括19个研究(n=9 133);结果显示,与野生型相比,DPYD*2A、c.2846A>T和*13三个位点的突变者服用氟尿嘧啶类药物发生3级以上毒性反应的风险明显较高(P<0.05)。结论:对于应用氟尿嘧啶类药物为基础化疗的肿瘤患者,建议用药前先检测DPYD*2A、c.2846A>T和*13基因型,若患者该基因发生突变,建议适当减少给药剂量或换用其他药物。OBJECTIVE To evaluate the influence of genetic polymorphism of DPYD＊2A,c.2846A〉Tand＊13 on patients with fluorouracil-related toxicity for its safe usage in clinic.METHODS Observational studies and clinical trials investigating the association between genetic polymorphism and fluorouracil-related toxicity were searched in electronic databases,including EMbase,PubMed,The Cochrane Library,Clinical Trials,CNKI,CBM and Wanfang,from the date of establishment to January 18,2016.Two review authors independently assessed,extracted and cross-checked data according to the literature inclusion and exclusion criteria.Data were analyzed by RevMan 5.2.RESULTS Nineteen clinical trials（n=9 133）were included.The results showed that there was statistical difference in the incidences of fluorouracil-related toxicity between DPYD＊2A,c.2846A〉Tand＊13carriers and patients with wild type（P〈0.05）.CONCLUSION DPYD＊2A,c.2846A〉Tand＊13carrier have higher risks to develop fluorouracil-related toxicity than wild type carriers.Therefore,it is suggested that patients before receiving fluorouracil should test DPYD＊2A,c.2846A〉Tand＊13to avoid toxicity.

关 键 词：氟尿嘧啶 毒性 DPYD META分析 

分 类 号：R969.3[医药卫生—药理学]