目的对人类细胞抗原(human leukocyte antigen system,HLA)基因多态性和药物性肝损害的关联性研究现状进行系统综述,并用meta分析的方法总结可能的诱发药物性肝损害的HLA基因多态性位点。方法主题词检索PubMed和EmBase电子数据库,根据预先设定的纳入排除标准对文献进行评价,对符合纳入标准的文献进行信息提取。对HLA-DRB1*15、*07、*03和HLA-DQB1*06、*02进行meta分析并计算合并OR值。结果纳入11篇文献共14个研究报道HLA基因多态性与药物性肝损害的关联。根据meta分析结果,药物性肝损害病例组与对照组相比,具有更高的HLA-DRB1*15、DQB1*06基因型比例(OR=2.82,95%CI:1.31~6.07,P〈0.001;OR=3.47,95%CI:1.77~6.81,P〈0.001)。结论 HLA-DRB1*15和HLA-DQB1*06基因型可能是药物性肝损害发生中的危险因素。
Objective To conduct a systematic review on the current studies on the relationship between polymorphism of human leukocyte antigen system(HLA) gene and drug-induced liver injury(DILI),and conduct a meta-analysis to synthesize possible risk of HLA genetic polymorphism on DILI.Methods Medical subject heading was used to search PubMed and EmBase database.Meta-analysis of the risk of HLA-DRB1*15,*07,*03 and HLA-DQB1*06,*02 on DILI were conducted.The outcome was measured using OR.Results 14 studies reported in 11 articles met the inclusion criterion.According to the results of meta-analysis,there was a higher proportion of HLA-DRB1*15 and DQB1*06 frequency in the DILI group(OR=2.82,95%CI:1.31-6.07,P0.001;OR=3.47,95%CI:1.77-6.81,P0.001).Conclusions The genotype of HLA-DRB1*15 and HLA-DQB1*06 may be the risk factors of the onset of DILI.