摘要
目的:估算CYP2C9基因多态性对华法林日平均剂量(Mean daily warfarin dose, MDWD)影响的定量关系,为临床个体化使用华法林提供参考。方法:计算机检索 Cochrane Library 和 PubMed(-2013年12月),根据纳入标准对文献进行筛选和评估,采用 RevMan 5.1软件及 Stata 12.0软件对数据进行 Meta 分析。结果:共纳入包括3902例患者在内的27个合格英文研究。CYP2C9基因型发生频率在各人群间存在差异。与CYP2C9*1/*1型相比,*1/*2型、*1/*3型、*2/*2型、*2/*3型和*3/*3型的 MDWD 分别下降0.20(95%CI :-0.24,-0.16)、0.31(95%CI :-0.35,-0.28)、0.40(95%CI :--0.47,-0.33)、0.52(95%CI :-0.59,-0.46)和0.81个标准单位(95%CI :-0.85,-0.76)。Begg 检验未发现明显发表性偏倚。结论:本研究获得了 CYP2C9基因多态性与华法林剂量个体间差异相关的定量关系,该定量关系可为临床设计华法林剂量个体化方案提供参考。
Objective: To quantify the influence of CYP2C9 genetic polymorphism on mean daily warfarin dose (MDWD) and provide reference for individualized warfarin therapy. Methods: Related databases of the Cochrane Library and PubMed were systematical y searched up to December 2013. Literatures were screened and evaluated according to the inclusion criteria. A meta-analysis was performed by RevMan 5.1 and Stata 12.0 software. Results: A total of 27 studies (3902 patients) were included. Compared to MDWD in CYP2C9*1/*1 carriers, that in patients with *1/*2, *1/*3,*2/*2, *2/*3 and *3/*3 genotype decreased by 0.20 (95%CI:-0.24, -0.16), 0.31(95%CI:-0.35, -0.28), 0.40(95%CI:-0.47, -0.33), 0.52(95%CI : -0.59, -0.46) and 0.81(95%CI :-0.85, -0.76), respectively. No significant publication biases were found by Begg test. Conclusion: The quantitative relationship between CYP2C9 genetic polymorphism and the individual warfarin dose is obtained, which might provide reference for personalized warfarin dosing.
出处
《临床药物治疗杂志》
2014年第3期30-36,共7页
Clinical Medication Journal
作者简介
通讯作者:李忠东E—mail:zhdl009@126.com