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- 2018
儿茶酚-O-甲基转移酶基因多态性rs4680对抗精神病药物疗效的影响
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Abstract:
摘要：目的 应用Meta分析的方法探讨儿茶酚-O-甲基转移酶(COMT)基因的主要单核苷酸多态性(SNP)rs4680对抗精神病药物疗效的影响。方法 检索Pubmed、Embase、Cochrane Library、中国知网和万方数据库，收集所有研究rs4680与抗精神病药物疗效的关系的文献，提取相关数据并用Stata14.0软件在显性模型下进行统计分析。以合并比值比(OR)和95%可信区间(95% CI)确定相关性；进行敏感性分析考察结果的稳定性；绘制漏斗图考察发表偏倚的大小。结果 共纳入13篇研究，包含1439例精神分裂症患者。合并结果显示，在显性模型下，rs4680显著影响抗精神病药物的疗效，与GG基因型携带者相比，AA或AG基因型携带者使用抗精神病药物治疗后获得的应答率更高(OR=1.31，95% CI：1.04～1.66)，Egger检验未发现显著的发表偏倚(P=0.082)，敏感性分析发现去掉漏斗图中离群的两个小样本研究后，合并结果无显著性差异(OR=1.25，95% CI：0.98～1.58)，表明meta分析结果存在一定的不稳定性。结论 rs4680可能会影响抗精神病药物的疗效，由于受到研究数目的限制以及不稳定性因素的存在，本结果仍需进一步验证。
ABSTRACT: Objective To investigate the effect of the main single nucleotide polymorphisms (SNP) rs4680of catechol-O-methyltransferase (COMT) gene on the efficacy of antipsychotic drugs by meta-analysis. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and the Wanfang Database were searched to identify studies which researched the association of rs4680 with the efficacy of antipsychotic drugs. The data were extracted and analyzed by Stata14.0 software under the dominant model. The correlation was determined by the odds ratio (ORs) and the 95% confidence interval (95% CI); the stability of the results was analyzed by the sensitivity analysis; the publication bias was investigated by funnel plot. Results A total of 13 studies were included, involving 1,439 schizophrenic patients. The pooled results showed that rs4680 significantly affected the efficacy of antipsychotic drugs in the dominant model. Compared with that of GG genotype carriers, the response rate of AA or AG genotype carriers treated with antipsychotic drugs was higher (OR=1.31, 95% CI: 1.04-1.66). The sensitivity analysis showed that after removing two small sample studies, the outliers of the funnel plot, the pooled results were not significantly different (OR=1.25, 95% CI: 0.98-1.58), indicating that there was a certain degree of instability in the meta-analysis results. Conclusion rs4680 may affect the efficacy of antipsychotic drugs. This result needs to be further validated due to the limitations of the number of studies and the presence of unstable factors
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