摘要
目的探讨急性淋巴细胞白血病(ALL)患儿中亚甲基四氢叶酸还原酶(MTHFR)基因C677T位点的多态性与甲氨蝶呤(MTX)毒副反应的相关性。方法通过检索Pub Med、Cochrane Library、Web of Science、Embase等数据库,收集建库至2016年8月1日关于ALL患儿M THFR C677T位点的多态性与M TX毒副反应的观察性队列研究,并提取基因型、MTX毒性相关资料进行方法学质量评价,采用Rev Man 5.3软件进行M eta分析。结果共纳入9篇文献进行M eta分析,结果显示,M THFR C677T多态性与肝毒性(如:CC vs.CT/TT,RR:0.81,95%CI:0.65~1.00,P=0.05)、血液毒性、黏膜毒性均不存在显著相关性。但单个研究显示,非洲人群在肝毒性、血液毒性、黏膜毒性(如:CC/CT vs.TT,RR:0.10,95%CI:0.03~0.39,P=0.000 9)方面,677C等位基因相对于其他人种而言具有较明显的保护作用。结论在ALL患儿中,MTHFR C677T不是一个好的预测MTX毒性的指标,两者的关系尚需要大样本量、高质量的研究来进一步验证。
Objective To systemically analyze the association between the C677 T polymorphisms of MTHFR and the toxicity of methotrexate（ MTX） in pediatric acute lymphoblastic leukemia（ ALL）. Methods The articles about association between MTHFR C677 T polymorphism and MTX-induced toxicity in pediatric ALL were achieved by searching Pub Med,Cochrane Library,Web of Science and Embase from the establishment of database to August 2016.The methodology quality was evaluated by extracting related information of genotype and MTX toxicity. Rev Man 5. 3software was applied to perform the Meta-analysis. Results Totally 9 studies were included. The Meta-analysis results indicated that there was no significant association between MTHFR C677 T and hepatotoxicity（ CC vs. CT/TT,RR：0. 81,95% CI： 0. 65 ~ 1. 00,P = 0. 05）,hematologic toxicity and mucositis. However,single study showed that the protective effect of 677 C was more obvious in the African on hepatotoxicity,hematologic toxicity and mucositis（ CC/CT vs. TT,RR： 0. 10,95% CI： 0. 03 ~ 0. 39,P = 0. 000 9）. Conclusion MTHFR C677 T polymorphisms do not seem to be a good marker of MTX-related toxicity in pediatric ALL. Large-sample and high-quality studies are required to verify the conclusions.
出处
《实用药物与临床》
CAS
2017年第9期1009-1014,共6页
Practical Pharmacy and Clinical Remedies
