CYP2C19基因多态性对伏立康唑药代动力学影响的系统评价

摘要

目的 系统评价CYP2C19基因多态性与伏立康唑药物代谢动力学的关系.方法 至2011年2月,计算机检索Cochrane图书馆、PubMed、Embase、Med-line、CNKI等数据库.收集有关CYP2C19基因多态性与伏立康唑药代动力学关系的研究.用RevMan 5.0软件对符合纳入标准的研究进行Meta分析.结果 共纳入10篇回顾性研究.其中,英文9篇,中文1篇.Meta分析结果表明,3种基因型对Cmax的影响没有统计学差异;3种基因型对AUC和T1/2的影响十分明显,PM基因型组的AUC和T1/2的值均大于HEM基因型组,且HEM基因型组均显著大于EM基因型组.基因型为EM人群的CL/F,明显大于PM基因型组;基因型为PM的人群Tmax,显著长于EM组;基因型为PM人群的MRT,显著大于EM人群.结论 伏立康唑代谢与CYP2C19基因多态性有显著相关性;但可能还受其他多种因素影响.%Objective To evaluate the influence of CYP2C19 genetic polymorphisms on voriconazole pharmacokinetics. Methods Cochrane library, PubMed, Embase, CNKI databases were searched by computer for investigating the influence of CYP2C19 genetic polymorphisms on voriconazole pharmacokinetics. The researches were reported before February 2010. The Meta analysis was performed by RevMan 5. 0 software. Results Ten retrospective studies, with 9 literatures in English and 1 literature in Chinese. The results of Meta analysis showed: There was no statistically significant among three genotypes of Cmax; Differences among the AUC and T1/2 is very obvious, PM genotype group were greater than the HEM genotype, and the HEM genotype group were significantly higher than EM genotype group. EM genotype group was significantly greater than PM genotype group in CL/F, PM genotype group was significantly longer than EM group in Tmax, PM genotype group was significantly greater than the EM group in MRT. Conclusion Voriconazole exposure is not only influenced by CYP2C19 genetic polymorphism, but by other reasons, and large sample prospective studies are needed.