中国药物警戒 ›› 2019, Vol. 16 ›› Issue (3): 154-156.

• 安全性评价与合理用药 • 上一篇    下一篇

HLA-B*5801基因多态性与别嘌醇致皮肤不良反应的文献分析

裴媛, 王瑞*, 王单单, 郭丽娜, 王博, 康鹤耀   

  1. 漯河市中心医院药学部,河南 漯河 462000
  • 收稿日期:2018-10-30 修回日期:2020-06-28 出版日期:2019-03-20 发布日期:2019-04-17
  • 通讯作者: 王瑞,男,主任药师,医院药学。E-mail: wr56116@163.com
  • 作者简介:裴媛,女,主管药师,药物基因检测及个体化治疗。

Literature Analysis of HLA-B*5801 Polymorphisms and Cutaneous Adverse Reactions Induced by Allopurinol

PEI Yuan, WANG Rui*, WANG Dandan, GUO Lina, WANG Bo, KANG Heyao   

  1. Department of Pharmacy, Luohe Central Hospital, Henan Luohe 462000, China
  • Received:2018-10-30 Revised:2020-06-28 Online:2019-03-20 Published:2019-04-17

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摘要： 目的 探讨HLA-B*5801等位基因变异与别嘌醇致皮肤不良反应之间的关联性,预测服用别嘌醇潜在的不良反应,为临床安全合理用药提供参考。方法 检索2005年3月~2018年5月中国学术期刊（网络版）、万方数字化期刊全文库、中文科技期刊全文数据库（维普）及PubMed 等数据库,收集HLA-B*5801等位基因变异与别嘌醇致皮肤不良反应（cutaneous adverse reactions,CAR）的文献进行统计和分析。结果 共检索到46篇文献,别嘌醇致CAR病例342例,HLA-B*5801等位基因阳性310例,阳性率90.64%,其中男性188例,女性122例,男性多于女性,年龄分布为18~91岁,以61~75岁患者多见。310例HLA-B*5801等位基因阳性患者发生CAR中,重度皮肤不良反应（severe cutaneous adverse reactions,SCAR）256例,占82.58%,轻度CAR 54例,占17.42%。服用100 mg别嘌醇与服药时间在21~30天患者不良反应发生率较高。结论 别嘌醇致CAR与HLA-B*5801等位基因有较强的关联性,另外患者性别、年龄、用药时间、用药剂量亦是不良反应的影响因素,在别嘌醇临床使用中应关注这些因素,并加强药学监护,以避免不良反应的发生,确保患者用药安全。

关键词: HLA-B*5801, 别嘌醇, 不良反应

Abstract: Objective To investigate the association between alleles of HLA-B*5801 and cutaneous adverse reactions induced by allopurinol, and predict potential adverse effects of allopurinol, so as to provide references for clinical safe and rational use of drugs. Methods Chinese Academic Journal (online), Wanfang Database, Chinese Science and Technology Journal Full-text Database (VIP), and PubMed databases were retrieved from March 2005 to May 2018, and then the documents of alleles of HLA-B*5801 and cutaneous adverse reactions(CAR) induced by allopurinol were collected for statistical analysis. Results A total of 46 literatures with 342 cutaneous adverse reactions patients were retrieved. There are 310 cases with positive allele of HLA-B*5801, with a positive rate of 90.64%. The males(188) are more than females(122) and the age distribution was 18~91 years old, especially 61~75 years old patients were more. Among the 310 patients with HLA-B*5801 positive allele, 256 cases were severe cutaneous adverse reactions (SCAR), accounting for 82.58%, and 54 cases were mild cutaneous adverse reactions, accounting for 17.42%. In addition, patients taking 100 mg allopurinol and taking it for 21~30 days had a higher incidence of adverse reactions. Conclusion There was strong association between alleles of HLA-B*5801 and cutaneous adverse reactions induced by allopurinol. In addition, gender, age, duration and dosage of medication were also influence factors of the adverse reactions. In clinical use of allopurinol, we should pay attention to these factors, and pharmaceutical care should be strengthened to avoid the occurrence of adverse reactions to ensure medication safety.

Key words: HLA-B*5801, allopurinol, adverse reactions

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