UGT1A6基因多态性对癫痫患者丙戊酸钠血药浓度的Meta分析  

Meta-analysis of Polymorphism of UGT1A6 Gene on Serum Valproate Concentration in Pilepsy Patients

作　　者：毛盼盼[1] 宋沧桑[1] 李兴德[1] 张函舒 王国徽 马雪娇 杨艳梅 MAO Pan-pan;SONG Cang-sang;LI Xing-de;ZHANG Han-shu;WANG Guo-hui;MA Xue-jiao;YANG Yan-mei(Kunming First People′s Hospital,Yunnan Kunming 650000,China;Hai yuan College of Kunming Medical University,Yunnan Kunming 650032,China)

机构地区：[1]昆明市第一人民医院,云南昆明650000 [2]昆明医科大学海源学院,云南昆明650032

出　　处：《中国药物评价》2024年第5期377-383,共7页Chinese Journal of Drug Evaluation

基　　金：云南省卫生健康委临床药学中心建设单位项目;云南省卫生健康委医学领军人才培养计划(No.L-2018012);昆明市卫生科技人才培养项目-医学科技领军人才培养计划[No.2023-SW(领军)-04];昆明市卫生科技人才培养项目-医学科技后备人才培养计划[No.2023-SW(后备)-11]。

摘　　要：目的:探讨UGT1A6 A541G、A552C基因多态对丙戊酸钠血药浓度的影响。方法:计算机检索PubMed、Medline、Cochrane Library、EMbase、CNKI、万方数据库,检索年限从建库至2024年4月,收集UGT1A6基因多态性与丙戊酸钠血药浓度文献,提取数据与质量评价,采用Revman5.3软件进行Meta分析。结果:共纳入文献11篇,999例癫痫患者。Meta分析结果显示,在UGT1A6 A541G基因中,除AG vs GG[MD=0.16,95%CI(-0.39,0.70),P=0.50]外,AA vs AG[MD=0.53,95%CI(0.32,0.75),P<0.00001],AA vs GG[MD=0.67,95%CI(0.10,1.23),P=0.02],AA vs AG+GG[MD=0.61,95%CI(0.45,0.76)P<0.00001],两者差异均具有统计学意义,说明癫痫患者UGT1A6 A541G AA型丙戊酸钠血药浓度高于AG型或/和GG型。在UGT1A6 A552C中,除AC vs CC[MD=0.21,95%CI(-0.31,0.74),P=0.43]外,AA vs AC[MD=0.90,95%CI(0.77,1.03),P<0.00001],AA vs CC[MD=0.90,95%CI(0.77,1.03),P<0.00001],AA vs AC+CC[MD=1.58,95%CI(1.07,2.10),P<0.00001],两者差异均具有统计学意义,说明UGT1A6 A552C AA型丙戊酸钠血药浓度高于AC型或/和CC型。结论:癫痫患者UGT1A6 A541G和A552C基因多态性与丙戊酸钠血药浓度具有相关性,且基因突变可能导致丙戊酸钠血药浓度降低。Objective:To investigate the effect of UGT1A6 A541G and A552C gene polymorphisms on the plasma concentration of sodium valproate.Methods:PubMed,Medline,Cochrane Library,EMbase,CNKI and Wanfang databases were searched by computer from the establishment of the database to April 2024.Literatures on UGT1A6 gene polymorphism and plasma concentration of sodium valproate were collected,data were extracted and quality was evaluated.Meta-analysis was performed using Revman5.3 software.Results:A total of 11 articles and 999 patients with epilepsy were included.Meta-analysis showed that AA vs AG[MD=0.53,95%CI(0.32,0.75),P<0.00001],AA vs GG[MD=0.67,95%CI(0.10,1.23),P=0.02],AA vs AG+GG[MD=0.61,95%CI(0.45,0.76),P<0.00001],there were statistical differences in addition to AG vs GG[MD=0.16,95%CI(-0.39,0.70),P=0.50]in the UGT1A6 A541G gene,indicating AA the blood concentration of sodium valproate in patients with epilepsy was higher than that of AG and/or GG.In UGT1A6 A552C,AA vs AC[MD=0.90,95%CI(0.77,1.03),P<0.00001],AA vs CC[MD=0.90,95%CI(0.77,1.03),P<0.00001],AA vs AC+CC[MD=1.58,95%CI(1.07,2.10),P<0.00001],there were statistical differences in addition to AC vs CC[MD=0.21,95%CI(-0.31,0.74),P=0.43],indicating AA the blood concentration of sodium valproate was higher than that in AC and/or CC.Conclusion:UGT1A6 A541G and A552C gene polymorphisms are associated with the plasma concentration of sodium valproate in patients with epilepsy,and gene mutations may lead to a decrease in the plasma concentration of sodium valproate.

关 键 词：丙戊酸钠血药浓度 GUT1A6 基因多态性 癫痫 META分析 

分 类 号：R927.2[医药卫生—药学]