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目的:观察抗结核药物性肝损害患者常见体质及其与CYP2E1基因多态性内在关联,阐明中医体质部分分子生物学基础,实现化疗方案的个体化。方法:将抗结核治疗中出现肝损害患者按中医体质辨识量表进行中医体质类型分型,运用多聚酶链反应技术(PCR)法检测CYP2E1基因多态性,分析临床常见体质、比较不同体质患者基因频率的差异。结果:(1)肝损害组患者气虚质分布频率明显高于对照组(P<0.05)、湿热质的分布频率显著高于对照组(P<0.01),平和质的分布频率显著低于对照组(P<0.01)。其他体质在两组间差异无统计学意义(P>0.05);(2)肝损害组cl/cl基因型分别频率明显高于高于对照组(χ2值7.686,P<0.05);cl/c2和c2/c2基因型的分布频率在两组中差异无统计学意义(P>0.05)。结论:中医体质因素和CYP2E1基因多态性与抗结核药物性肝损害密切相关,对指导结核病的个体化治疗、预防肝损害有重要意义。
Objective: To observe the common physique of patients with anti-tuberculosis drug-induced liver injury and their association with CYP2E1 gene polymorphism, to clarify the molecular biology of TCM constitution and to achieve the individualization of chemotherapy regimens. Methods: The patients with liver damage during anti-TB therapy were divided into TCM constitution according to TCM identification scale. CYP2E1 gene polymorphism was detected by polymerase chain reaction (PCR), and clinical common physical constitution, Frequency difference. Results: (1) The frequencies of qi deficiency in liver damage group were significantly higher than those in control group (P <0.05), the frequency of moist heat was significantly higher than that in control group (P <0.01), and the distribution frequency of allelopathia was significantly lower than that in control group (P <0.01). (2) The frequencies of cl / cl genotypes in liver injury group were significantly higher than those in control group (χ2 = 7.686, P <0.05), while cl / c2 And c2 / c2 genotype distribution frequency in the two groups, the difference was not statistically significant (P> 0.05). Conclusion: TCM constitutional factors and CYP2E1 gene polymorphism are closely related to anti-tuberculosis drug-induced liver injury, which is of great importance to guide the individualized treatment of tuberculosis and prevent liver damage.