中国临床药理学杂志
中國臨床藥理學雜誌
중국림상약이학잡지
THE CHINESE JOURNAL OF CLINICAL PHARMACOLOGY
2015年
4期
292-296
,共5页
他克莫司%肾移植%CYP3A4*1G%系统评价
他剋莫司%腎移植%CYP3A4*1G%繫統評價
타극막사%신이식%CYP3A4*1G%계통평개
tacrolimus%renal transplant%CYP3A4*1G%Meta analysis
目的：系统评价CYP3A4*1G基因多态性对肾移植受者他克莫司日剂量、全血谷浓度及浓度剂量比的影响。方法计算机检索 EmBase、PubMed、Cochrane Library、CNKI、万方及SinoMed等数据库，收集CYP3A4*1G基因多态性对他克莫司给药剂量及血药浓度影响的研究，用Revman 5．2软件进行Meta分析。结果共纳入7项研究（中文5篇，英文2篇），包括750名成年肾移植受者。 Meta分析结果表明，CYP3A4*1G组他克莫司日剂量显著高于CYP3A4*1／*1组患者（ P＜0．05）。亚组分析显示，肾移植术后14 d内，2组他克莫司日剂量比较差异无统计学意义（ P ＞0．05）；而术后1个月及2～3个月时， CYP3A4*1G组他克莫司日剂量均显著高于CYP3A4*1／*1组（均P＜0．05），他克莫司全血谷浓度及浓度剂量比均显著低于CYP3A4*1／*1组（均P＜0．05）。结论 CYP3A4*1G基因多态性显著影响肾移植受者他克莫司日剂量及其血药浓度。
目的：繫統評價CYP3A4*1G基因多態性對腎移植受者他剋莫司日劑量、全血穀濃度及濃度劑量比的影響。方法計算機檢索 EmBase、PubMed、Cochrane Library、CNKI、萬方及SinoMed等數據庫，收集CYP3A4*1G基因多態性對他剋莫司給藥劑量及血藥濃度影響的研究，用Revman 5．2軟件進行Meta分析。結果共納入7項研究（中文5篇，英文2篇），包括750名成年腎移植受者。 Meta分析結果錶明，CYP3A4*1G組他剋莫司日劑量顯著高于CYP3A4*1／*1組患者（ P＜0．05）。亞組分析顯示，腎移植術後14 d內，2組他剋莫司日劑量比較差異無統計學意義（ P ＞0．05）；而術後1箇月及2～3箇月時， CYP3A4*1G組他剋莫司日劑量均顯著高于CYP3A4*1／*1組（均P＜0．05），他剋莫司全血穀濃度及濃度劑量比均顯著低于CYP3A4*1／*1組（均P＜0．05）。結論 CYP3A4*1G基因多態性顯著影響腎移植受者他剋莫司日劑量及其血藥濃度。
목적：계통평개CYP3A4*1G기인다태성대신이식수자타극막사일제량、전혈곡농도급농도제량비적영향。방법계산궤검색 EmBase、PubMed、Cochrane Library、CNKI、만방급SinoMed등수거고，수집CYP3A4*1G기인다태성대타극막사급약제량급혈약농도영향적연구，용Revman 5．2연건진행Meta분석。결과공납입7항연구（중문5편，영문2편），포괄750명성년신이식수자。 Meta분석결과표명，CYP3A4*1G조타극막사일제량현저고우CYP3A4*1／*1조환자（ P＜0．05）。아조분석현시，신이식술후14 d내，2조타극막사일제량비교차이무통계학의의（ P ＞0．05）；이술후1개월급2～3개월시， CYP3A4*1G조타극막사일제량균현저고우CYP3A4*1／*1조（균P＜0．05），타극막사전혈곡농도급농도제량비균현저저우CYP3A4*1／*1조（균P＜0．05）。결론 CYP3A4*1G기인다태성현저영향신이식수자타극막사일제량급기혈약농도。
Objective To systematically assess the effects of CYP3A4*1G genetic polymorphism on daily dose of tacrolimus, tacrolimus trough concentration and dose-adjusted trough concentration.Methods The EmBase, PubMed, Cochrane Library, CNKI, WanFang and SinoMed databases were searched, and related literature were manually searched focused on the influence of CYP3A4*1G genetic polymorphism on daily dose of tacrolimus and drug concentrations.The Meta-analysis was per-formed by Revman 5.2 software.Results A total of seven studies ( five papers in Chinese and two papers in English ) were included, involving 750 adult renal transplant recipients.The results of meta -analysis re-vealed that the CYP3A4*1G carriers need higher weight-adjusted daily dose of tacrolimus than the patients carried CYP3A4 * 1/* 1 ( P<0.05) .A subgroup analysis revealed that there was no significant diffe-rence between the two groups two weeks after renal transplant, but at one month and two three months after transplant, the CYP3A4*1G carriers required higher weight-adjusted daily dose of tacrolimus than the patients carried CYP3 A4*1/*1 . Besides, CYP3 A4 *1 G carriers showed a lower tacrolimus trough concentration and dose-ad-justed trough concentration compared with CYP3 A4*1/*1 carriers ( P <0.05 ) . Conclusion CYP3 A4*1 G genetic polymorphism significantly influences the daily dose of tacrolimus and drug concentration in adult renal transplant recipients.
