CYP2C19基因多态性对序贯疗法根除幽门螺杆菌感染疗效影响的Meta分析

Meta-analysis of influence of CYP2C19 genetic polymorphisms on sequential therapy on helicobacter pylori infection eradication

目的系统评价CYP2C19基因多态性与序贯疗法根除幽门螺杆菌感染疗效的关系,以期为使用序贯疗法前是否需检测CYP2C19基因多态性提供循证参考。方法检索PubMed、Embase、Cochranelibrary、CBM、WanFang、CNKI、CQVIP等数据库,收集CYP2C19基因多态性与序贯疗法根除幽门螺杆菌感染的临床研究。根据纳入和排除标准筛选、评价文献与提取数据后,采用RevMan5.3进行Meta分析。结果共纳入3篇文献,包含331例对象,Meta分析结果显示:CYP2C19强代谢型(EM)、中间代谢型(IM)与弱代谢型(PM)间序贯疗法的幽门螺杆菌根除率无统计学差异(EMvsIM:94.1%vs93.8%,OR=1.08,95%CI(0.41,2.86);EMvsPM:94.1%vs83.3%,OR=2.86,95%CI(0.97,8.40);IMvsPM:93.8%vs83.3%,OR=2.72,95%CI(0.94,7.90);P>0.05)。结论药物代谢酶CYP2C19基因多态性不影响序贯疗法的幽门螺杆菌感染根除率,提示选择序贯疗法作为根除方案时不需要检测CYP2C19基因多态性。

Objective To systematically review the influence of drug metabolizing enzyme CYP2C19 genetic polymorphisms on sequential therapy for Helicobacter pylori infection eradication.Methods Databases such as PubMed, Embase,Cochrane library,CBM,WanFang data,CNKI and CQVIP were electronically searched for clinical studies on CYP2C19 genetic polymorphisms and sequential therapy and Helicobacter pylori.According to the inclusion and exclusion criteria,literatures were screened,and data were extracted,and the methodologically quality of included studies were also examined.Meta-analysis was then performed using RevMan 5.3 software.Results Three studies involving 331 subjects were included.The results of meta-analysis showed that CYP2C19 genetic polymorphism did not influence eradication rates of Helicobacter pylori in the regimen of sequential therapy(EM vs.IM:94.1% vs 93.8%,OR=1.08,95%CI(0.41,2.86);EM vs.PM:94.1% vs 83.3%,OR=2.86,95% CI (0.97,8.40);IM vs. PM:93.8% vs 83.3%,OR=2.72,95% CI (0.94,7.90);P>0.05).Conclusion CYP2C19 genetic polymorphism did not influence the efficacy of sequential therapy, therefore CYP2C19 genetic polymorphism test was not required if sequential therapy was chosen as eradication regimen for Helicobacter pylori infection.