中国人群血小板抵抗与血小板糖蛋白受体基因相关性的荟萃分析
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摘要
目的:系统评价中国冠心病患者血小板抵抗与血小板糖蛋白受体基因的相关性。方法:计算机检索PubMed、Embase、Cochrane图书馆、CNKI、VIPH和万方数据库,检索时间截至2018年6月。纳入有关血小板抵抗与血小板糖蛋白受体基因相关性的临床试验,根据Cochrane Handbook 5.0.2质量评价标准评价纳入研究的质量。采用RevMan 5.0软件对数据进行定量合并分析。结果:共纳入7个研究1 611例患者,包括抗血小板药物抵抗组772例,对照组839例。Meta分析结果显示,虽有个别研究显示血小板抵抗与血小板糖蛋白受体基因T、C相关,但将已报道的中国人群血小板抵抗与血小板糖蛋白受体基因的所有研究结果综合来看,血小板抵抗与血小板糖蛋白受体基因无明显相关性。T等位基因与C等位基因[OR=0.39,95%CI:(0.11,1.31),P=0.13]、基因型TT+TC与CC[OR=0.33,95%CI:(0.06,1.76),P=0.19]、基因型TT与CC[OR=0.50,95%CI:(0.12,2.13),P=0.35]、基因型TC与CC[OR=0.25,95%CI:(0.03,2.21),P=0.21]均与血小板抵抗无明显关系。结论:中国人群血小板抵抗与血小板蛋白受体基因无明显相关性。
Objective:To evaluate the relationship between platelet resistance and platelet glycoprotein platelet receptor gene in patients with coronary heart disease.Method:We searched PubMed,Embase,Cochrane Library,CNKI,VIPH and Wanfang database,and the deadline is June 2018.Clinical trials concerning on the correlation between platelet resistance and platelet glycoprotein receptor gene were included,the quality of the included studies were evaluated with Cochrane Handbook 5.0.2 Quality evaluation criteria.RevMan 5.0software was used to merge and analyze the data quantitatively.Result:Seven papers with 1 611 cases were enrolled,including 772 patients with platelet resistance and 839 controls.Meta-analysis showed that although individual studies suggested that there was a relationship between platelet resistance and platelet glycoprotein receptor gene T and C,we found there was no significant correlation after combined all results of included studies together.Allele T and C [OR=0.39,95%CI:(0.11,1.31),P=0.13],genotype TT + TC and CC [OR=0.33,95%CI:(0.06,1.76),P=0.19],genotype TT and CC [OR=0.50,95%CI:(0.12,2.13),P=0.35],genotype TC and CC [OR=0.25,95%CI:(0.03,2.21),P=0.21]had no significant relationship with platelet resistence.Conclusion:There is no significant correlation between platelet resistence and platelet receptor gene in Chinese people.
Objective:To evaluate the relationship between platelet resistance and platelet glycoprotein platelet receptor gene in patients with coronary heart disease.Method:We searched PubMed,Embase,Cochrane Library,CNKI,VIPH and Wanfang database,and the deadline is June 2018.Clinical trials concerning on the correlation between platelet resistance and platelet glycoprotein receptor gene were included,the quality of the included studies were evaluated with Cochrane Handbook 5.0.2 Quality evaluation criteria.RevMan 5.0software was used to merge and analyze the data quantitatively.Result:Seven papers with 1 611 cases were enrolled,including 772 patients with platelet resistance and 839 controls.Meta-analysis showed that although individual studies suggested that there was a relationship between platelet resistance and platelet glycoprotein receptor gene T and C,we found there was no significant correlation after combined all results of included studies together.Allele T and C [OR=0.39,95%CI:(0.11,1.31),P=0.13],genotype TT + TC and CC [OR=0.33,95%CI:(0.06,1.76),P=0.19],genotype TT and CC [OR=0.50,95%CI:(0.12,2.13),P=0.35],genotype TC and CC [OR=0.25,95%CI:(0.03,2.21),P=0.21]had no significant relationship with platelet resistence.Conclusion:There is no significant correlation between platelet resistence and platelet receptor gene in Chinese people.
引文
[1]王毅博,彭瑜,张钲.血小板分布宽度与冠心病的研究进展[J].临床心血管病杂志,2018,34(7):731-733.
[2]李为民,臧雁翔.冠心病双联抗血小板治疗优化策略的思考[J].临床心血管病杂志,2018,34(10):943-945.
[3]Chen WH,Cheng X,Lee PY,et al.Aspirin resistance and adverse clinical events in patients with coronary artery disease[J].Am J Med,2007,120(7):631-635.
[4]Preston F,Whipps S,Jackson C,et al.Inhibition of prostacyclin and platelet thromboxane A2after lowdose aspirin[J].N Engl J Med,1981,304(2):76-79.
[5]王蓓芸,谈世进,胡剑平.老年患者血小板膜糖蛋白Ⅲa基因血小板抗原T_C多态性与阿司匹林抵抗的研究[J].中华老年心脑血管病杂志,2012,14(3):287-289.
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[7]苏冠华,王朝晖,丁艳萍,等.血小板膜糖蛋白Ia807C/T多态性与阿司匹林抵抗的关系[J].中国血液流变学杂志,2007,17(1):43-82.
[8]辛晓敏,张云平,金英玉.血小板膜糖蛋白IaC807T多态性与阿司匹林抵抗的研究[J].现代检验医学杂志,2009,24(2):5-7.
[9]金英玉,辛晓敏,张云平,等.阿司匹林抵抗与血小板GPIba多态性Kozak序列的研究[J].哈尔滨医科大学学报,2009,43(12):30-32.
[10]茅新蕾,颜雪琴,韩丽雅,等.阿司匹林抵抗与GPⅢa基因多态性的相关性研究[J].现代实用医学,2011,23(1):18-21.
[11]刘菊,黄婷,梅群超.阿司匹林抵抗与血小板膜GPIIb/IIIa受体基因多态性的相关性[J].医药导报,2013,32(3):328-331.
[12]Karim S,Habib A,Lévy-Toledano S,et al.Cyclooxygenase-1and-2of endothelial cells utilize exogenous or endogenous arachidonic acid for transcellular production of thromboxane[J].J Biol Chem,1996,271(20):12042-12048.
[13]Saw J,Madsen EH,Chan S,et al.The ELAPSE(E-valuation of Long-Term Clopidogrel Antiplatelet and Systemic Anti-Inflammatory Effects)study[J].J Am Coll Cardiol,2008,52(23):1826-1833.
[14]Malinin AI,Callahan KP,Serebruany VL.Paradoxical activation of major platelet receptors in the methadone-maintained patients after single pill of aspirin[J].Thromb Res,2001,104(4):297-299.
[15]Macchi L,Christiaens L,Brabant S,et al.Resistance to aspirin in vitro is associated with increased platelet sensitivity to adenosine diphosphate[J].Thromb Res,2002,107(1-2):45-49.
[16]Schmitz G,Rothe G,Ruf A,et al.European working group on clinical cell analysis:consensus protocol for the flow cytometric characterization of platelet function[J].Thromb Haemost,1998,79(5):885-896.
[17]Fuchs I,Frossard M,Spiel A,et al.Platelet function in patients with acute coronary syndrome(ACS)predicts recurrent ACS[J].J Thromb Haemost,2006,4(12):2547-2552.
[18]杨进刚,许海燕,杨跃进,等.中国省、市和县级医院急性ST段抬高型心肌梗死住院患者再灌注治疗和二级预防用药分析[J].中国循环杂志,2017,32(1):12-16.
[2]李为民,臧雁翔.冠心病双联抗血小板治疗优化策略的思考[J].临床心血管病杂志,2018,34(10):943-945.
[3]Chen WH,Cheng X,Lee PY,et al.Aspirin resistance and adverse clinical events in patients with coronary artery disease[J].Am J Med,2007,120(7):631-635.
[4]Preston F,Whipps S,Jackson C,et al.Inhibition of prostacyclin and platelet thromboxane A2after lowdose aspirin[J].N Engl J Med,1981,304(2):76-79.
[5]王蓓芸,谈世进,胡剑平.老年患者血小板膜糖蛋白Ⅲa基因血小板抗原T_C多态性与阿司匹林抵抗的研究[J].中华老年心脑血管病杂志,2012,14(3):287-289.
[6]李春晓.血小板膜糖蛋白(GP)Ⅲa PLA、Ia807C/T基因多态性与阿司匹林抵抗的相关性研究[C].青岛大学,2011.
[7]苏冠华,王朝晖,丁艳萍,等.血小板膜糖蛋白Ia807C/T多态性与阿司匹林抵抗的关系[J].中国血液流变学杂志,2007,17(1):43-82.
[8]辛晓敏,张云平,金英玉.血小板膜糖蛋白IaC807T多态性与阿司匹林抵抗的研究[J].现代检验医学杂志,2009,24(2):5-7.
[9]金英玉,辛晓敏,张云平,等.阿司匹林抵抗与血小板GPIba多态性Kozak序列的研究[J].哈尔滨医科大学学报,2009,43(12):30-32.
[10]茅新蕾,颜雪琴,韩丽雅,等.阿司匹林抵抗与GPⅢa基因多态性的相关性研究[J].现代实用医学,2011,23(1):18-21.
[11]刘菊,黄婷,梅群超.阿司匹林抵抗与血小板膜GPIIb/IIIa受体基因多态性的相关性[J].医药导报,2013,32(3):328-331.
[12]Karim S,Habib A,Lévy-Toledano S,et al.Cyclooxygenase-1and-2of endothelial cells utilize exogenous or endogenous arachidonic acid for transcellular production of thromboxane[J].J Biol Chem,1996,271(20):12042-12048.
[13]Saw J,Madsen EH,Chan S,et al.The ELAPSE(E-valuation of Long-Term Clopidogrel Antiplatelet and Systemic Anti-Inflammatory Effects)study[J].J Am Coll Cardiol,2008,52(23):1826-1833.
[14]Malinin AI,Callahan KP,Serebruany VL.Paradoxical activation of major platelet receptors in the methadone-maintained patients after single pill of aspirin[J].Thromb Res,2001,104(4):297-299.
[15]Macchi L,Christiaens L,Brabant S,et al.Resistance to aspirin in vitro is associated with increased platelet sensitivity to adenosine diphosphate[J].Thromb Res,2002,107(1-2):45-49.
[16]Schmitz G,Rothe G,Ruf A,et al.European working group on clinical cell analysis:consensus protocol for the flow cytometric characterization of platelet function[J].Thromb Haemost,1998,79(5):885-896.
[17]Fuchs I,Frossard M,Spiel A,et al.Platelet function in patients with acute coronary syndrome(ACS)predicts recurrent ACS[J].J Thromb Haemost,2006,4(12):2547-2552.
[18]杨进刚,许海燕,杨跃进,等.中国省、市和县级医院急性ST段抬高型心肌梗死住院患者再灌注治疗和二级预防用药分析[J].中国循环杂志,2017,32(1):12-16.