ABCB1基因多态性与糖皮质激素性股骨头坏死相关性的Meta分析

发布时间：2018-06-16 00:32

  本文选题：糖皮质激素 + 股骨头坏死　； 参考：《中国医院药学杂志》2016年09期

【摘要】：目的:系统评价患者长期或大剂量应用糖皮质激素后发生股骨头坏死与ABCB1C3435T、ABCB1G2677T/A基因多态性的关系,期望为其安全使用提供证据。方法:计算机检索EMbase、PubMed、The Cochrane Library、Clinical Trials、CNKI、CBM、万方和维普数据库,查找关于激素性股骨头坏死(SANFH)与ABCB1C3435T、ABCB1G2677T/A基因多态性的关系的观察性研究和临床试验,检索时限均从建库截至2015年6月25号。对符合条件的研究,由2位研究者按照纳入和排除标准,独立筛选文献、提取资料、评价文献质量,并交叉核对后,采用Stata 12.0软件进行荟萃分析。结果:共纳入8篇文献,包括8个研究(n=1 297);结果显示应用糖皮质激素后,ABCB1C3435T携带者(CT或TT型)与野生型患者(CC型)的SANFH发生率存在统计学差异(P0.05);ABCB1G2677T/A则无统计学差异(P=0.15)。结论:对于长期或大剂量应用糖皮质激素的患者,ABCB1(C3435T)T携带者发生SANFH的风险较低。因此,建议用药前先检测ABCB1C3435T基因型,再考虑是否单用糖皮质激素或联合双膦酸盐治疗。
[Abstract]:Objective: to evaluate systematically the relationship between the necrosis of femoral head and ABCB1C3435T ABCB1G2677T / A gene polymorphism after long-term or high-dose glucocorticoid administration in order to provide evidence for its safe use. Methods: a computerized search for the Cochrane Library Clinical Trialsl CBM, Wannfang and Wiper databases was conducted to find out the relationship between SANFH and ABCB1C3435T / ABCB1G2677T / A gene polymorphism and clinical trials. The search time was from the establishment of the database to June 25, 2015. According to the criteria of inclusion and exclusion, the two researchers independently sifted the literature, extracted the data, evaluated the quality of the documents, and cross-checked, and then analyzed them by Stata 12.0 software. Results: a total of 8 articles were included, including 8 studies, and the results showed that the incidence of SANFH in ABCB1C3435T carriers (CT or TT) and wild-type patients (CC type) was significantly different from that in wild-type patients (P0.05, ABCB1G2677T / A), but there was no significant difference in SANFH incidence between ABCB1C3435T carriers and wild-type patients (P0.05G2677T / A). Conclusion: there is a lower risk of SANFH in ABCB1 C3435 T T carriers in patients with long term or high dose glucocorticoid use. Therefore, it is recommended that ABCB1C3435T genotypes be detected before medication and whether to use glucocorticoid or bisphosphonates alone.
【作者单位】： 郑州大学第一附属医院药学部;
【基金】：河南省医学科技攻关计划(编号:201403019)
【分类号】：R681.8
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本文编号：2024371