【摘要】 目的 评价中国汉族人群亚甲基四氢叶酸还原酶(MTHFR)的基因多态性与大剂量甲氨蝶呤用于急性淋巴细胞白血病患者的不良反应发生的相关性。方法 检索Pub Med、Embase、Cochrane Library、中国知网、万方、维普等数据库,收集中国汉族人群MTHFR C677T及A1298C基因多态性与甲氨蝶呤治疗急性淋巴细胞白血病产生的不良反应关联性的研究,按纳入和排除标准筛选文献、提取数据并对文献进行质量分析,采用Rev Man 5.3软件进行Meta分析。结果 共纳入11篇文献,其中关于MTHFR C677T研究11篇,关于A1298C研究6篇。MTHFR 677CC型皮疹的发生风险低于677CT/TT型[RR=3.82,95%CI(1.30,11.26),P=0.01],不良反应总发生率及其余各类型不良反应发生风险差异无显著意义(P>0.05)。MTHFR 1298AA型与1298AC/CC型相比,不良反应总发生率及各类型不良反应发生风险差异无显著意义(P>0.05)。结论 在中国汉族人群中,MTHFR C677T基因多态性可能与患者使用大剂量甲氨蝶呤后产生皮疹有一定的相关性。更多还原

【Abstract】 AIM To evaluate the association of methylenetetrahydrofolate reductase(MTHFR) genetic polymorphisms with the adverse drug reactions of high dose methotrexate(MTX) therapy for acute lymphoblastic leukemia(ALL) in Chinese Han populations. METHODS The Pub Med, Embase, Cochrane Library, CNKI,Wanfang, and VIP database were searched. For collecting the case of MTHFR C677T and A1298C genetic polymorphisms in Chinese Han population with adverse reactions of MTX in the treatment of acute lymphoblastic leukemia. Literatures were screened according to the inclusion and exclusion criteria. Data were extracted and analyzed for quality of the literature. And meta-analysis was performed by using Rev Man 5.3 software. RESULTS A total of 11 articles were included, all of them involved MTHFR C677T and 6 of them involved A1298C. The risk of MTHFR 677CC rash was lower than 677CT/TT( RR = 3.82, 95% CI(1.30, 11.26), P = 0.01).There were no significant differences in the total adverse drug reactions and other types of adverse drug reactions( P > 0.05). There were no significant differences in the total adverse drug reactions and different types of adverse drug reactions between MTHFR 1298AA and 1298AC/CC(P > 0.05). CONCLUSION MTHFR C677T genetic polymorphisms may have an impact on rashes in patients who use large doses of MTX in Chinese Han populations.更多还原