海南省汉族人群HLA-B*5801基因多态性与别嘌醇所致不良反应的相关性研究
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篇名: 海南省汉族人群HLA-B*5801基因多态性与别嘌醇所致不良反应的相关性研究
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摘要: 目的:探讨海南省汉族人群HLA-B*5801基因多态性与别嘌醇所致不良反应的相关性。方法:对海南省人民医院2015年9月-2017年9月住院的149例使用别嘌醇的患者采用原位杂交荧光染色分析技术检测其HLA-B*5801等位基因,根据其不良反应情况分为耐受组和不良反应组,应用Woolf’s公式计算比值比(OR),分析HLA-B*5801等位基因与别嘌醇不良反应发生的相关性。结果:149例患者中耐受组133例,其中17.29%(23/133)携带HLA-B*5801等位基因;不良反应组16例,其中93.75%(15/16)携带HLA-B*5801等位基因。发生不良反应的16例患者中,13例为皮肤及其附件损伤、1例为全身性损害,1例为胃肠系统损害,1例为中枢及外周神经系统损害。携带HLA-B*5801等位基因患者发生不良反应的风险显著高于不携带HLA-B*5801等位基因患者(OR:71.74,95%CI:9.02~570.55,P<0.000),其中发生皮肤及其附件损伤与HLA-B*5801等位基因也呈强相关性(OR:57.39,95%CI:7.11~463.50,P<0.000)。结论:海南省汉族人群HLA-B*5801等位基因与别嘌醇所致不良反应具有强相关性,建议本地区汉族患者开始服用别嘌醇前先检测HLA-B*5801等位基因,有助于减少别嘌醇所致不良反应的发生。
ABSTRACT: OBJECTIVE: To investigate the relationship between HLA-B*5801 gene polymorphism and allopurinol-induced ADR in the Han population of Hainan Province. METHODS: The in-situ hybridization fluorescence staining analysis technique was used to detect HLA-B*5801 allele of 149 inpatients receiving allopurinol in Hainan Provincial People’s Hospital during Sept. 2015-Sept. 2017. They were divided into tolerance group and ADR group according to ADR. Woolf’s formula was used to calculate OR. The correlation of HLA-B*5801 allele with the occurrence of allopurinol-induced ADR was analyzed. RESULTS: Of 149 patients, there were 133 cases in tolerance group, among which 17.29% (23/133) carried HLA-B*5801 allele. There were 16 cases in ADR group, among which 93.75%(15/16) carried HLA-B*5801 allele. Among 16 ADR patients, 13 patients suffered from lesion of skin and its appendents; 1 patient suffered from systemic damage; 1 patient suffered from gastrointestinal systemic damage; 1 patient suffered from central and peripheral nervous system damage. The risk of ADR in patients with HLA-B*5801 allele was significantly higher than patients without HLA-B*5801 allele(OR:71.74,95%CI:9.02-570.55,P<0.000). The lesion of skin and its appendents was strongly associated with HLA-B*5801 allele (OR:57.39, 95%CI: 7.11-463.50, P<0.000). CONCLUSIONS: HLA-B*5801 allele is strongly associated with allopurinol-induced ADR. It is suggested that HLA-B*5801 allele of Han patients should be detected before taking allopurinol, which helps to reduce the incidence of allopurinol-induced ADR.
期刊: 2018年第29卷第9期
作者: 云雄,吴丹娜,韩方璇,黄春新,彭文兴
AUTHORS: YUN Xiong,WU Danna,HAN Fangxuan,HUANG Chunxin,PENG Wenxing
关键字: HLA-B*5801;别嘌醇;基因多态性;不良反应;海南省;汉族
KEYWORDS: HLA-B* 5801; Allopurinol; Gene polymorphism; ADR; Hainan province; Han population
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