临床儿科杂志
臨床兒科雜誌
림상인과잡지
2013年
8期
733-736
,共4页
陆爱东%张乐萍%王彬%贾月萍%左英熹%吴珺%黄山雅美%胡冠华%刘桂兰
陸愛東%張樂萍%王彬%賈月萍%左英熹%吳珺%黃山雅美%鬍冠華%劉桂蘭
륙애동%장악평%왕빈%가월평%좌영희%오군%황산아미%호관화%류계란
多药耐药基因1%还原性叶酸载体%基因多态性%急性淋巴细胞白血病%甲氨蝶呤
多藥耐藥基因1%還原性葉痠載體%基因多態性%急性淋巴細胞白血病%甲氨蝶呤
다약내약기인1%환원성협산재체%기인다태성%급성림파세포백혈병%갑안접령
multidrug resistance gene 1%reduced folate carrier%genetic polymorphism%acute lymphoblastic leuke-mia%methotrexate
目的研究多药耐药基因1（MDR1）和还原型叶酸载体基因（SLC19A1）多态性对儿童急性淋巴细胞白血病（ALL）大剂量甲氨喋呤（MTX）治疗疗效及不良反应的影响。方法应用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）技术，对108例ALL患者MDR1 exon26C＞T、MDR1 exon21G＞T/A和SLC19A180G＞A基因多态性进行分析；并分析基因型和生存率、不良反应等的关系。结果 MDR1 exon26C＞T、MDR1 exon21G＞T/A和SLC19A180G＞A各基因型的36个月生存率差异无统计学意义；MDR1 exon26C＞T和MDR1 exon21G＞T/A突变型的24 h MTX血浆浓度高于野生型，且突变型具有更高的肝功能损伤发生率，差异均有统计学意义（P<0.05）。结论 MDR1 exon26C＞T和MDR1 exon21G＞T/A基因突变对大剂量MTX治疗血浆浓度及肝功能损伤有明显影响。
目的研究多藥耐藥基因1（MDR1）和還原型葉痠載體基因（SLC19A1）多態性對兒童急性淋巴細胞白血病（ALL）大劑量甲氨喋呤（MTX）治療療效及不良反應的影響。方法應用基質輔助激光解吸電離飛行時間質譜（MALDI-TOF MS）技術，對108例ALL患者MDR1 exon26C＞T、MDR1 exon21G＞T/A和SLC19A180G＞A基因多態性進行分析；併分析基因型和生存率、不良反應等的關繫。結果 MDR1 exon26C＞T、MDR1 exon21G＞T/A和SLC19A180G＞A各基因型的36箇月生存率差異無統計學意義；MDR1 exon26C＞T和MDR1 exon21G＞T/A突變型的24 h MTX血漿濃度高于野生型，且突變型具有更高的肝功能損傷髮生率，差異均有統計學意義（P<0.05）。結論 MDR1 exon26C＞T和MDR1 exon21G＞T/A基因突變對大劑量MTX治療血漿濃度及肝功能損傷有明顯影響。
목적연구다약내약기인1（MDR1）화환원형협산재체기인（SLC19A1）다태성대인동급성림파세포백혈병（ALL）대제량갑안첩령（MTX）치료료효급불량반응적영향。방법응용기질보조격광해흡전리비행시간질보（MALDI-TOF MS）기술，대108례ALL환자MDR1 exon26C＞T、MDR1 exon21G＞T/A화SLC19A180G＞A기인다태성진행분석；병분석기인형화생존솔、불량반응등적관계。결과 MDR1 exon26C＞T、MDR1 exon21G＞T/A화SLC19A180G＞A각기인형적36개월생존솔차이무통계학의의；MDR1 exon26C＞T화MDR1 exon21G＞T/A돌변형적24 h MTX혈장농도고우야생형，차돌변형구유경고적간공능손상발생솔，차이균유통계학의의（P<0.05）。결론 MDR1 exon26C＞T화MDR1 exon21G＞T/A기인돌변대대제량MTX치료혈장농도급간공능손상유명현영향。
Objectives To investigate the inlfuence of polymorphisms of SLC19A1 80G>A, MDR1 exon26C>T and MDR1 exon21G>T/A on curative effect and adverse reaction of high-dose methotrexate in patients with acute lymphoblastic leukemia. Methods MALDI-TOF-MS technique was used to detect the polymorphisms of SLC19A1 80G>A, MDR1 exon 26C>T and MDR1 exon21G>T/A in 108 patients with acute lymphoblastic leukemia (ALL). The relationship of genetic polymorphism, survival rate and toxicity was analyzed. Results The 36-month event-free survival was not related to any polymorphisms of MDR1 and SLC19A1. Patients with mutant types of MDR1 exon26C>T and MDR1 exon21G>T/A showed a much higher MTX plasma levels at 24 hours and higher incidence of hepatic injury (P<0.05). Conclusions The genetic polymorphism of MDR1 exon26>T, MDR1 exon21G>T/A has a large inlfuence on hepatic toxicity and plasma concentra-tions of MTX.
