OPRM1基因A118G多态性对癌痛患者阿片类药物使用剂量影响的Meta分析  

Effects of A118G Polymorphism of OPRM1 Gene on the Dosage of Opioids in Population Patients with Cancer Pain: a Meta-analysis

作　　者：陈倩倩[1] 李颖[2] 申楚翘 孙立[2] 汪永忠[2] Chen Qianqian;Li Ying;Shen Chuqiao;Sun Li;Wang Yongzhong(Anhui University of Chinese Medicine,Hefei 230031,China;Departmnet of Phamracy,the Frist Affiliated Hospital of Auhui University of Chinese Medicine)

机构地区：[1]安徽中医药大学,合肥230031 [2]安徽中医药大学第一附属医院药学部

出　　处：《药物流行病学杂志》2018年第7期454-459,共6页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:系统评价μ阿片受体基因(OPRM1)A118G多态性对癌痛患者阿片类药物使用剂量的影响,为其个体化用药提供参考。方法:计算机检索The Cochrane Library、PubMed、Embase、Medline、CNKI、WanFang Data和VIP数据库,搜索有关癌痛患者OPRM1基因A118G多态性和阿片类药物使用剂量的相关文献,检索年限均从各数据库建库起至2017年12月31日。由两位评价员独立筛选文献、提取资料、评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果:纳入5项研究,共459例患者。OPRM1基因A118G多态性检测结果分为突变纯合子(GG)基因型、野生杂合子(AG)基因型、野生纯合子(AA)基因型。Meta分析结果显示:GG基因型患者阿片类镇痛药的需要量较AG基因型高[SMD=-39.74,95%CI(-59.20,-20.28),P<0.001];GG基因型患者阿片类镇痛药的需要量较AA基因型高[SMD=-48.77,95%CI(-68.01,-29.53),P<0.000 1]。结论:基于目前研究表明OPRM1基因A118G单核苷酸多态性与患者阿片类镇痛药物使用剂量有相关性,携带G等位基因的癌痛患者阿片类药物的使用剂量更多。Objective：To provide reference for the individualized treatment of opioid drugs by investigating the effects of OPRM1 gene All8G polymorphism on opioids dosage in patients with cancer pain. Methods： The Cochrane Library, PubMed, Embase, Medline, CNKI, WanFang Data and VIP database were searched to collect studies about A118G polymorphism of OPRM1 gene and dose of opioids in patients with cancer pain, the retrieval time was from the establishment to December 31, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, Meta-analysis was performed by RevMan 5.3 software. Results： A total of five articles with 459 patients were included. Genetic testing showed that OPRM1 gene A118G polymorphism divided into mutant homozygote GG, wild-type heterozygous AG and wild homozygous AA. The results of single group rate meta-analysis showed, the does of opioid analgesics for patients with mutant homozygote GG was higher than the wild-type heterozygous AG [ SMD = - 39.74, 95% CI （ - 59.20, - 20.28 ）, P 〈 0.001 ], the does of opioid analgesics for patients with mutant homozygote GG was higher than wild homozygous AA [ SMD = - 48.77, 95% CI（ - 68.01, - 29.53 ）, P 〈 0. 000 1 ]. Conclusion： Based on current research showed that OPRM1 gene A118G single nucleotide polymorphisms were associated with patients carrying the G-allele increased the requirement of opioids.

关 键 词：μ阿片受体基因 多态性 阿片类药物 癌痛 剂量 META分析 

分 类 号：R968[医药卫生—药理学]