中国成人肾移植病人药物基因组学研究的系统评价  

Systematic evaluation of pharmacogenomic studies in adult chinese kidney transplantation patients

作　　者：吴微 吴毓婷 吴小山 杨燕飞 汪电雷 史天陆 WU Wei;WU Yuting;WU Xiaoshan;YANG Yanfei;WANG Dianlei;SHI Tianlu(School of Pharmacy,Anhui University of Chinese Medicine,Hefei,Anhui 230012,China;Department of Pharmacy,the First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei,Anhui 230001,China;Anhui Key Laboratory of Precision Pharmaceutical Preparation and Clinical Pharmacy,Hefei,Anhui 230001,China)

机构地区：[1]安徽中医药大学药学院,安徽合肥230012 [2]中国科学技术大学附属第一医院(安徽省立医院)药学部,安徽合肥230001 [3]精准药物制剂与临床药学安徽省重点实验室,安徽合肥230001

出　　处：《安徽医药》2025年第5期1045-1051,共7页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省质量基础设施标准化专项(2022MKS06);安徽省高校自然科学研究项目(2023AH040397)。

摘　　要：目的通过系统评价方法分析我国成人肾移植病人中治疗药物与基因的关系,总结与药物相关的基因,为临床肾移植受者个体化用药提供循证医学参考。方法计算机检索CNKI、VIP、Pubmed、Web of Science和万方数据库,检索时间均为建库起至2024年9月,纳入涉及中国成人肾移植中治疗药物与基因的相关文献,分析相关基因与药物剂量和浓度、合并用药、药动学以及不良反应之间的关联性,并对结果进行描述性分析。结果共纳入89篇文献,发表时间为2008―2024年,研究样本为35~845例,受者年龄分布在18~79岁。研究发现与血药浓度/药物剂量相关基因包括CYP3A5、CYP3A4、ABCB1等22种;与药动学相关基因包括CYP3A5、ABCB1、UGT等7种;与不良反应相关基因包括CYP3A5、CYP3A4、ABCB1等11种。结论中国成人肾移植病人中治疗药物的基因组学研究发展迅速,所涉及的基因种类众多,其中与血药浓度/药物剂量相关基因22种;与药动学相关基因7种;与不良反应相关基因11种,通过病人的基因分型可更科学地使用治疗药物。未来仍需要开展更多多中心、大样本、高质量研究进一步明确相关基因与药物作用关系,提高药物疗效和安全。Objective To systematically evaluate the current status of research on therapeutic drugs and genes in adult renal transplant recipients in China,and to summarise drug-related genes,so as to provide evidence-based medical references for the individualisation of drugs in clinical renal transplant recipients.Methods Computer searches of CNKI,VIP,Pubmed,Web of Science and Wanfang databases were performed from the time of database construction to September 2024,and relevant literature involving therapeutic drugs and genes in Chinese adult renal transplantation was included to analyse the correlation between the relevant genes and drug dosage and concentration,co-administration of medications,pharmacokinetics,and adverse reactions,and descriptive analyses were performed on the results.The results were analysed descriptively.Results A total of 89 papers were included,published between 2008 and 2024,with a study sample of 35-845 cases and an age distribution of recipients between 18 and 79 years.The study found 22 genes related to blood concentration/drug dose,including CYP3A5,CYP3A4 and ABCB1;7 genes related to pharmacokinetics,including CYP3A5,ABCB1,and UGT;and 11 genes related to adverse effects,including CYP3A5,CYP3A4 and ABCB1.Conclusions The genomics of therapeutic drugs in Chinese adult kidney transplant patients is developing rapidly and involves a large number of genes,including 22 genes related to blood concentration/dosage,7 genes related to pharmacokinetics,and 11 genes related to adverse effects,which can be used more scientifically by genotyping patients.In the future,more multi-center,large-sample,high-quality studies are needed to further clarify the relationship between related genes and drug effects,and to improve drug efficacy and safety.

关 键 词：肾移植 药物基因组学 系统评价 

分 类 号：R699.2[医药卫生—泌尿科学]