摘要
目的:系统评价我国癫痫患者药物治疗相关基因的研究现状,总结与药物使用相关的基因,为癫痫疾病的治疗提供循证医学证据的参考。方法:计算机检索CBM,CNKI,VIP和万方数据库,检索时间为建库至2017年1月,纳入评价癫痫疾病药物治疗相关基因的文献,分析相关基因与癫痫治疗耐药性、药物疗效、不良反应、血药浓度、药物使用剂量之间的关联性,对研究结果进行描述性分析。结果:共纳入49篇文献,发表时间为2007–2016年,整体文献发表量呈上升趋势。研究样本为2~654例。研究发现影响抗癫痫药物血药浓度的基因包括UGTl A4、UGT1A6、CYP3A4、CYP3A5、CYP2C9、CYP2C19、ABCC2和UGT2B7。影响药物疗效的基因包括SCN1A、ABCB1、CYP2C19和MDR1。与药品不良反应相关基因包括HLA和EPHX1。对抗癫痫药物使用剂量有影响的包括ABCC2-24C>T和CYP2C19。结论:癫痫药物基因组学的研究发展迅猛,涉及到的相关基因呈现多样化、复杂化,但研究样本量不大、有对照组的研究不多,且关于基因与不良反应和给药剂量关系的研究较少,大部分单次研究的基因与癫痫的关联性还有待今后高质量、大样本的临床研究验证。
Objective：To systematically review the current studies of gene-based drug treatment in Chinese epilepsy patients in order to provide evidence for the treatment of epilepsy.Methods：We searched several databases including CBM,CNKI,VIP and Wanfang databases from inception to January 2017.Papers focusing on the association between related genes and antiepileptic drug resistance,drug efficacy,adverse drug reactions,serum drug concentration and drug dosage were included and descriptively analyzed.Results：A total of 49 articles published from 2007 to 2016 were included.The overall quantity was increasing.Study samples varied between 2 and 654 cases.Genes that could affect the blood serum concentration of drugs were UGTlA4,UGT1A6,CYP3A4,CYP3A5,CYP2C9,CYP2C19,ABCC2,and UGT2B7.In addition,SCN1A,ABCB1,CYP2C19 and MDR1 could affect the efficacy of drugs.The HLA and EPHX1 were positively associated with adverse drug reactions.Genes that could affect the drug dose were ABCC2-24C〉T and CYP2C19.Conclusion：The research of pharmacogenomics researches on anti-epileptic drugs developed rapidly,and the related genes were diverse and complicated.However,the sample size was small.Few studies used control group in study design.And there was rare research on the relationship between genes and adverse drug reactions and drug efficacy.Most of the studies were needed to be validated by further clinical studies with high-quality and large samples.
出处
《中国药物应用与监测》
CAS
2017年第5期259-262,共4页
Chinese Journal of Drug Application and Monitoring
基金
国家自然科学基金项目(81373381)
关键词
癫痫
药物基因组学
循证评价
Epilepsy
Pharmacogenomics
Systematical review
