摘要
目的研究亚甲基四氢叶酸还原酶(MTHFR)和三磷酸腺苷(ATP)结合盒B亚家族成员1转运蛋白(ABCB1)基因多态性对血液系统恶性肿瘤患者大剂量甲氨蝶呤(HD-MTX)化学治疗后排泄延迟和肝肾毒性的影响。方法选取徐州医科大学附属医院2019年4月至2020年5月收治行HD-MTX治疗的血液系统恶性肿瘤成年患者131例,监测甲氨蝶呤(MTX)血药浓度,并检测MTHFR与ABCB1基因分型,统计并分析患者用药前后肝肾功能。结果 131例患者中,MTHFR 677位点和ABCB1 3435位点(CT+TT)型携带者MTX排泄延迟发生率与CC型携带者相当(P> 0.05);ABCB1 3435位点(CT+TT)型携带者肝功能损伤的发生率明显高于CC型携带者(P <0.05)。结论 ABCB1 3435位点(CT+TT)型基因多态性与血液系统恶性肿瘤成年患者使用HD-MTX后肝功能损伤相关。
Objective To study the effect of MTHFR and ABCB1 genetic polymorphism on the elimination delay of high-dose methotrexate(HD-MTX)and the hepatorenal toxicity of patients with hematologic malignancies.Methods Totally 131 adult patients with hematologic malignancies treated with HD-MTX in the Affiliated Hospital of Xuzhou Medical University from April 2019 to May2020 were selected.The blood concentration of MTX was monitored,the genotypes of MTHFR and ABCB1 were detected,and the hepatorenal function before and after treatment was analyzed.Results Among 131 patients,the incidence of MTX-elimination delay in MTHFR 677 and ABCB13435(CT+TT)genotype carriers was similar to that in CC genotype carriers(P>0.05),the incidence of liver function injury in ABCB13435(CT+TT)genotype carriers was significantly higher than that in CC genotype carriers(P<0.05).Conclusion ABCB13435(CT+TT)genetic polymorphism is associated with HD-MTX-liver injury in adult patients with hematological malignancies.
作者
马乐
韩佳
吕冬梅
MA Le;HAN Jia;LYU Dongmei(Xuzhou Medical University,Xuzhou,Jiangsu,China;Department of Pharmacy,The Affiliated Hospital of Xuzhou Medical University,XuZhou,Jiangsu,China 221002)
出处
《中国药业》
CAS
2021年第6期40-43,共4页
China Pharmaceuticals
基金
江苏省徐州市卫生健康委2020年青年医学科技创新项目[XWKYHT20200061]。
关键词
大剂量
甲氨蝶呤
血液系统恶性肿瘤
排泄延迟
基因多态性
肝肾毒性
high-dose
methotrexate
hematologic malignancies
elimination delay
genetic polymorphisms
hepatorenal toxicity
