摘要
目的探讨细胞色素P450家族2亚家族C成员19(CYP2C19)基因多态性对2岁以下急性淋巴细胞白血病(ALL)患儿易感性及伏立康唑血药浓度的影响。方法选取53例2岁以下血液系统疾病患儿,其中ALL患儿37例,非ALL患儿16例,分别作为ALL组(n=37)和非ALL组(n=16)。检测两组患儿CYP2C19基因型分布情况[快代谢型(EM)、中间代谢型(IM)和慢代谢型(PM)]及对ALL患儿易感性、伏立康唑血药浓度的影响,记录不良反应发生情况。结果ALL组患儿中,EM型20例,IM型12例,PM型5例,CYP2C19基因型分布均衡且符合Hardy-Weinberg平衡定律检验。两组患儿CYP2C19基因型分布情况比较,差异无统计学意义(P﹥0.05)。在正常浓度下,PM型患儿在用药第4、7天的血药浓度均高于EM、IM型,差异均有统计学意义(P﹤0.05)。EM、IM、PM型ALL组患儿皮疹、畏光、腹泻、呕吐发生率比较,差异均无统计学意义(P﹥0.05)。结论CYP2C19基因型在2岁以下ALL患儿中分布均衡,对患儿易感性影响不明显,但可明显影响伏立康唑的血药浓度。
Objective To investigate the influence of cytochrome P450 family 2 subfamily C member 19(CYP2C19)gene polymorphism on susceptibility and voriconazole blood concentration in children with acute lymphoblastic leukemia(ALL)under 2 years old.Method A total of 53 children with hematological diseases under 2 years old were selected,including 37 cases with ALL and 16 cases without ALL,which was divided into ALL group(n=37)and non-ALL group(n=16),respectively.The distribution of CYP2C19 genotypes[extensive metabolizer(EM),intermediate metabolizer(IM),and poor metabolizer(PM)]in two groups were detected,and influence on susceptibility of ALL and voriconazole blood concentration were analyzed,and the adverse reactions were recorded.Result In ALL group,there were 20 cases of EM type,12 cases of IM type,and 5 cases of PM type,the CYP2C19 genotype distribution was balanced and met the Hardy-Weinberg equilibrium test.There was no statistically significant difference in the distribution of CYP2C19 genotypes between the two groups(P>0.05).At normal concentrations,the blood drug concentrations of PM type children were higher than those of EM type and IM type on the 4th and 7th day of medication,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidences of rash,photophobia,diarrhea,and vomiting among ALL children with EM,IM,and PM type(P>0.05).Conclusion The CYP2C19 genotype is evenly distributed in children with ALL under 2 years old,and has little effect on their susceptibility,but can significantly affect the blood concentration of voriconazole.
作者
韩雪
董静
高晓静
冶鹏娟
潘梦瑾
崔建坡
HAN Xue;DONG Jing;GAO Xiaojing;YE Pengjuan;PAN Mengjin;CUI Jianpo(Department of Hematology,Kaifeng Children’s Hospital,Kaifeng 475000,He’nan,China;Pediatric Intensive Care Unit,Kaifeng Children’s Hospital,Kaifeng 475000,He’nan,China;Department of Pharmacy,Kaifeng Children’s Hospital,Kaifeng 475000,He’nan,China)
出处
《癌症进展》
2025年第11期1306-1309,1347,共5页
Oncology Progress
基金
2022年度开封市科技发展计划项目(2203106)。
