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目的探讨氯吡格雷抵抗与ABCB1 3435C>T基因位点多态性关联性。方法计算机检索Pubmed、Science direct、Wiley online library、Web of Science、中国知网、万方数据库和维普中文科技期刊数据库,纳入氯吡格雷抵抗与氯吡格雷有效的随机对照试验,同时查阅检索结果中所附相似文献及参考文献,检索文献均为建库至2014年6月25日,采用Rev Man5.0软件进行Meta分析及其他统计学分析。结果共纳入文献6篇;患者中氯吡格雷抵抗2 619例、氯吡格雷有效2 799例。Meta分析结果显示,3435C>T位点多态性在等位基因模型、显性基因模型、共显性基因模型(CC/CT)和超显性基因模型下整体效应有统计学意义(P<0.05):等位基因模型OR=1.27,95%CI(1.13,1.42),显性基因模型OR=1.42,95%CI(1.22,1.65),共显性基因模型(CC/CT)OR=1.43,95%CI(1.20,1.69),超显性基因模型OR=1.30,95%CI(1.11,1.52)。人种亚组分析表明,欧洲地区ABCB1 3435C>T位点基因多态性与氯吡格雷抵抗均无统计学意义(P>0.05);而亚洲地区ABCB1 3435C>T位点基因多态性与氯吡格雷抵抗在等位基因模型、显性基因模型、共显性基因模型(CC/CT)和超显性基因模型下整体效应有统计学意义(P<0.05):等位基因模型OR=1.57,95%CI(1.34,1.84),显性基因模型OR=2.11,95%CI(1.71,2.60)、共显性基因模型(CC/CT)OR=2.15,95%CI(1.72,2.69),超显性基因模型OR=1.82,95%CI(1.48,2.24)。结论亚洲地区,ABCB1 3435C>T位点基因多态性与氯吡格雷抵抗有相关性,而在欧洲地区则无相关性。
Objective To investigate the association between clopidogrel resistance and ABCB1 3435C> T gene polymorphism. Methods The databases of Pubmed, Science direct, Wiley online library, Web of Science, CNKI, Wanfang database and VIP Chinese Journal of Science and Technology were included in this study. Randomized controlled trials of clopidogrel resistance and clopidogrel were included in the search results Attached to the similar literature and references, the search literature are building database to June 25, 2014, the use of Rev Man5.0 Meta-analysis software and other statistical analysis. Results A total of 6 articles were included in the literature; 2 619 cases of clopidogrel resistance and 2 799 cases of clopidogrel were effective. The results of meta-analysis showed that the overall effect of 3435C> T polymorphism in allele, dominant gene model, co-dominant gene model (CC / CT) and super-dominant gene model was statistically significant (P < 0.05). The odds ratio (OR) was 1.27, 95% CI (1.13, 1.42) for allelic model, OR = 1.42,95% CI for dominant gene model , 95% CI (1.20,1.69), and over-dominant gene model OR = 1.30,95% CI (1.11,1.52). Sub-group analysis showed that there was no significant difference in ABCB1 3435C> T locus polymorphism and clopidogrel resistance in Europe (P> 0.05), while the polymorphism of ABCB1 3435C> T locus in Asia was not associated with chlorine The overall effect of the Pigeon resistance in the allele, dominant gene model, co-dominant gene model (CC / CT) and super-dominant gene model was statistically significant (P <0.05): allele model OR = 1.57 , 95% CI (1.34,1.84) respectively, OR = 2.11,95% CI (1.71,2.60), CC / CT OR = 2.15,95% CI The over-dominant gene model OR = 1.82,95% CI (1.48,2.24). Conclusion In Asia, the polymorphism of ABCB1 3435C> T locus is related to clopidogrel resistance, but not in Europe.