CYP2C19基因多态性对兰索拉唑药动学影响的系统评价
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篇名: CYP2C19基因多态性对兰索拉唑药动学影响的系统评价
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摘要: 目的:系统评价CYP2C19基因多态性对兰索拉唑药动学的影响,为其临床个体化用药提供循证依据。方法:计算机检索PubMed、EMBase、Web of science、Cochrane图书馆、中国期刊全文数据库,收集有关CYP2C19基因多态性对兰索拉唑药动学影响的回顾性研究,对符合纳入标准的研究进行资料提取和质量评价,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入11项回顾性研究,合计200例健康受试者,基因类型分为纯合子快代谢型(EM)、杂合子快代谢型(HEM)及慢代谢型(PM)。Meta分析结果显示,CYP2C19基因多态性显著影响兰索拉唑的峰浓度(cmax)、血药浓度-时间曲线下面积(AUC)、半衰期(t1/2)、达峰时间(tmax)和清除率(CL/F)。cmax、AUC PM组>HEM组>EM组;CL/F EM组>HEM组>PM组;t1/2 PM组>HEM组和EM组,而HEM组与EM组比较差异无统计学意义;tmax HEM组和PM组均>EM组,而HEM组与PM组比较差异无统计学意义。结论:CYP2C19基因多态性对兰索拉唑的药动学有显著影响,是引起兰索拉唑药物治疗效应与不良反应个体间差异的重要因素,临床应针对不同基因类型的患者施以个体化的治疗方案。
ABSTRACT: OBJECTIVE: To systematically review the effect of CYP2C19 genetic polymorphism on lansoprazole pharmacokinetics, and provide evidence-based reference for clinical individualized medication of lansoprazole. METHODS: Retrieved from PubMed, EMBase, Web of science, Cochrane Library and CJFD, retrospective studies about the effect of CYP2C19 genetic polymorphism on lansoprazole pharmacokinetics were collected, Meta-analysis was performed by Rev Man 5.2 software after data extract and quality evaluation. RESULTS: Totally 11 retrospective studies were included, involving 200 patients. The gene type included homozygote express metabolizers (EM), heterozygous express metabolizers (HEM) and slow metabolizers (PM). Results of Meta-analysis showed CYP2C19 polymorphism significantly affected cmax, AUC, t1/2, tmax and CL/F. The cmax and AUC in group PM were higher than group HEM and group EM; CL/F in group EM was higher than group HEM and group PM; t1/2 in group PM was higher than group HEM and group EM, while there was no significant difference in the t1/2 between group HEM and group EM; tmax in HEM and group PM were higher than group EM, while there was no significant difference in the tmax between group PM and group HEM. CONCLUSIONS: CYP2C19 genetic polymorphism shows obvious effect on lansoprazole pharmacokinetics, which is the key factor for causing efficacy of lansoprazole and individual differences among adverse reactions, and clinic should take into account individualized dose regimen of lansoprazole.
期刊: 2016年第27卷第21期
作者: 刘一,贾琳,黄婧,徐国防,周媛,任晓蕾,张春燕,冯婉玉
AUTHORS: LIU Yi,JIA Lin,HUANG Jing,XU Guofang,ZHOU Yuan,REN Xiaolei,ZHANG Chunyan,FENG Wanyu
关键字: 兰索拉唑;CYP2C19;药动学;基因多态性;系统评价
KEYWORDS: Lansoprazole; CYP2C19; Pharmacokinetics; Genetic polymorphism; Systematic review
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