目的 系统评价人类白细胞抗原B(human leukocyte antigen B,HLA-B)基因多态性与抗癫痫药拉莫三嗪致皮肤不良反应(lamotrigine-cutaneous adverse reactions,LTG-cADRs)的相关性.方法 通过计算机全面检索中国期刊全文数据库、万方数字化期刊全文库、中国科技期刊全文数据库、PubMed、Web of Science、Science Direct数据库,检索时间截至2022年7月15日,采用RevMan5.4软件进行meta分析.结果 共纳入16篇病例对照研究,331例LTG-cADRs癫痫患者,其中94例拉莫三嗪致史-约综合征/中毒性表皮坏死松懈症(lamotrigine-Stevens-Johnson syndrome/toxic epidermal necrolysis,LTG-SJS/TEN)患者,232 例拉莫三嗪致斑丘疹(lamotrigine-maculopapule,LTG-MPE)患者,5 例伴嗜酸粒细胞增多和系统症状的药疹(lamotrigine-drug rash with eosinophilia and systemic symptoms,LTG-DRESS)患者;612 例拉莫三嗪耐受癫痫患者.Meta分析结果显示:HLA-B*1502等位基因与LTG-SJS/TEN存在显著相关性(OR=3.03,95％CI:1.70～5.39,P=0.000 2).HLA-B*1502、HLA-B*5801、HLA-B*1302 等位基因均与 LTG-MPE 无显著相关性.结论 HLA-B*1502等位基因与LTG-SJS/TEN存在相关性,可能是LTG-SJS/TEN风险基因;HLA-B*1502、HLA-B*5801和HLA-B*1302等位基因与LTG-MPE无相关性.
Abstract
OBJECTIVE To systematically evaluate the association between human leukocyte antigen B(HLA-B)gene polymorphisms and lamotrigine-induced cutaneous adverse drug reactions(LTG-cADRs).METHODS CNKI,Wanfang Data,VIP,PubMed,Web of Science,Science Direct were comprehensively searched from the inception to July 15,2022.The software RevMan 5.4 was used for the meta-analysis.RESULTS A total of 16 case-control studies were included,331 patients with LTG-cADRs epilepsy,including 94 lamotrigine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis(LTG-SJS/TEN)patients,232 lamotrigine-maculopapule(LTG-MPE)patients and 5 lamotrigine-drug rash with eosinophilia and systemic symptoms(LTG-DRESS)patients;612 lamotrigine-tolerant patients.Meta-analysis results showed that the HLA-B*1502 allele was significantly associated with LTG-SJS/TEN(OR=3.03,95％CI:1.70-5.39,P=0.000 2).The HLA-B*1502,HLA-B*5801,HLA-B*1302 alleles were not significantly associated with LTG-MPE.CONCLUSION HLA-B*1502 allele is associated with LTG-SJS/TEN,which may be a risk gene for LTG-SJS/TEN.HLA-B*1502,HLA-B*5801,HLA-B*1302 are not associated with LTG-MPE.
关键词
HLA-B/拉莫三嗪/皮肤不良反应/癫痫/meta分析
Key words
HLA-B/lamotrigine/cutaneous adverse drug reactions/epilepsy/meta-analysis
维普
万方数据