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目的:探讨类风湿性关节炎患者GGH-401C＞T基因多态性与甲氨蝶呤有效性和毒性的相关性.方法:系统检索中国生物医学文献数据库,中国期刊全文数据库,维普数据库,万方数据库,Pubmed,Embase和Cochranelibrary数据库,检索文献截至2017年11月.筛选与类风湿关节炎患者GGH基因多态性与甲氨蝶呤有效性和毒性相关的研究,纳入符合标准的研究并进行数据提取和质量评价,应用Revman5.3软件进行meta分析.结果:共纳入5篇研究.Meta分析结果显示在甲氨蝶呤有效性方面,GGH-401C＞T等位基因C/T的合并OR值为0.94(95％CI:0.72～1.21),P=0.61,差异无统计学意义;基因型的隐性、显性和超显性对照模型分析结果显示,差异均无统计学意义.在毒性方面,GGH-401C＞T等位基因C/T的合并OR值为1.19 (95％CI:0.92～1.55),P=0.19,差异无统计学意义;基因型的隐性和超显性对照模型分析结果显示,差异也无统计学意义,但在显性对照模型中显示出统计学趋势(P=0.09),剔除Lima的研究后,差异有统计学意义(P=0.05).结论:GGH-401C＞T多态性与类风湿性关节炎患者甲氨蝶呤应答的相关性不明显,但CC型患者的不良反应发生率可能高于CT型和TT型患者.“,”Objective:To evaluate the association of GGH-401C＞T polymorphism with the responsiveness to and toxicity of methotrexate in rheumatoid arthritis with a meta analysis.Methods:CBM,CNKI,VIP,Wanfang,Pubmed,Embase and Cochrane library databases were systematically searched up to November 2017 with two independent reviewers screened the relevant literatures.The studies met our inclusion criteria were included for data extraction and quality assessment.The meta-analysis was conducted with RevMan 5.3 software.Results:A total of 5 studies were included.meta-analysis showed no association between GGH-401C＞T polymorphism and methotrexate responsiveness (OR=0.94,95％CI:0.72～1.21),P=0.61.And no association could be detected in the analysis of MTX-related toxicity (OR=1.19,95％CI:0.92～1.55),P=0.19.However,a marginal power in the dominant model was observed (CC vs CT+TT:OR:1.49,95％CI:0.94～2.36),P=0.09,and when the study of Lima was removed,it showed a statistical significance with OR:2.39,95％CI:1.02～5.59,P=0.05.Conclusion:Our meta-analysis showed no significant association between GGH-401C＞T polymorphism and the efficacy of methotrexate but there was a slight trend that CC genotype might result in a higher incidence of adverse events compared with CT and TT carriers.