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目的系统评价MDR1G2677T/A基因多态性与环孢素药物代谢动力学及药效学的关系。方法计算机检索Cochrane图书馆、Pubmed、EMBase、Medline、CNKI等数据库,检索时间截止至2008年10月。收集有关MDR1 G2677T/A基因多态性与环孢素药代动力学及药效关系的研究。采用Revman 5.0软件对符合纳入标准的研究进行Meta分析。结果共纳入7篇回顾性研究包括844例肾移植患者,其中英文5篇,中文2篇。Meta分析结果表明,GG基因型患者的剂量调整谷浓度明显低于其他基因型患者(P<0.05),同时GG基因型患者的给药后2 h剂量调整浓度及平均日剂量与(TT+TA+AA)基因型患者之间有显著差异(P<0.05),而与(GT+GA)基因型患者之间无显著差异(P>0.05),G2677T/A基因多态性与急性排斥反应发生率之间无统计学意义的相关性(P>0.05)。结论G2677T/A基因多态性与环孢素处置有显著相关性,但与急性排斥反应发生率没有关联,同时尚需高质量大样本量的前瞻性研究来证实。
Objective To systematically evaluate the relationship between MDR1G2677T / A polymorphism and cyclosporine pharmacokinetics and pharmacodynamics. Methods The databases of Cochrane Library, Pubmed, EMBase, Medline and CNKI were searched by computer. The search time was up to October 2008. To investigate the relationship between MDR1 G2677T / A polymorphism and cyclosporine pharmacokinetics and pharmacodynamics. Meta-analysis of studies that met the inclusion criteria was performed using Revman 5.0 software. Results A total of 7 retrospective studies included 844 renal transplant recipients, including 5 English and 2 Chinese. The results of Meta analysis showed that the dose-adjusted trough concentrations in GG genotype patients were significantly lower than those in other genotypes (P <0.05). Meanwhile, the dose-adjusted concentration and average daily dose at 2 h after GG genotype were (P <0.05), but no significant difference (P> 0.05) between patients with genotype (+ GA) and those with genotype (GT + GA). The polymorphism of G2677T / A gene was associated with acute rejection There was no significant correlation between rates (P> 0.05). Conclusion The genetic polymorphism of G2677T / A is significantly correlated with the treatment of cyclosporine but not with the incidence of acute rejection, and a large prospective study with high quality is needed.