PDF(Pubmed)
Abstract：
BACKGROUND: The association between cytochrome P450 2C19 (CYP2C19) polymorphisms and neurological deterioration in stroke or transient ischemic attack (TIA) patients is not completely understood. Hence, we performed a systematic review and meta-analysis of prospective cohort studies to quantify this association.
METHODS: PubMed, Cochrane Library, Excerpta Medica Database, China National Knowledge Infrastructure and WanFang databases were searched for studies published up to April 2019. Prospective cohort studies that reported an association between CYP2C19 polymorphisms and neurological deterioration in stroke/TIA patients were included. Data on risk ratio (RR) and 95% confidence intervals (CI) were extracted and pooled by the authors. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed.
RESULTS: Twelve eligible studies were included. Twelve studies reported CYP2C19∗2, ∗3 loss-of-function alleles and 5 studies reported CYP2C19∗17 gain-of-function allele. Compared to non-carriers, carriers of CYP2C19∗2, ∗3 loss-of-function alleles had a significantly higher risk of neurological deterioration (RR, 1.63; 95%CI, 1.32-2.02). Conversely, carriers of CYP2C19∗17 gain-of-function allele had a significantly lower risk of neurological deterioration (RR, 0.520; 95%CI, 0.393-0.689) compared to non-carriers.
CONCLUSIONS: This meta-analysis demonstrated that the carriers of CYP2C19∗2, ∗3 loss-of-function alleles have an increased risk of neurological deterioration compared to non-carriers in stroke or TIA patients. Additionally, CYP2C19∗17 gain-of-function allele can reduce the risk of neurological deterioration.
METHODS: PubMed, Cochrane Library, Excerpta Medica Database, China National Knowledge Infrastructure and WanFang databases were searched for studies published up to April 2019. Prospective cohort studies that reported an association between CYP2C19 polymorphisms and neurological deterioration in stroke/TIA patients were included. Data on risk ratio (RR) and 95% confidence intervals (CI) were extracted and pooled by the authors. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed.
RESULTS: Twelve eligible studies were included. Twelve studies reported CYP2C19∗2, ∗3 loss-of-function alleles and 5 studies reported CYP2C19∗17 gain-of-function allele. Compared to non-carriers, carriers of CYP2C19∗2, ∗3 loss-of-function alleles had a significantly higher risk of neurological deterioration (RR, 1.63; 95%CI, 1.32-2.02). Conversely, carriers of CYP2C19∗17 gain-of-function allele had a significantly lower risk of neurological deterioration (RR, 0.520; 95%CI, 0.393-0.689) compared to non-carriers.
CONCLUSIONS: This meta-analysis demonstrated that the carriers of CYP2C19∗2, ∗3 loss-of-function alleles have an increased risk of neurological deterioration compared to non-carriers in stroke or TIA patients. Additionally, CYP2C19∗17 gain-of-function allele can reduce the risk of neurological deterioration.
摘要：
背景：细胞色素P4502C19（CYP2C19）多态性与卒中或短暂性脑缺血发作（TIA）患者神经功能恶化之间的关联尚未完全了解。因此，我们对前瞻性队列研究进行了系统评价和荟萃分析,以量化这种关联.
方法：PubMed，科克伦图书馆,摘录医学数据库，搜索了截至2019年4月发表的《中国国家知识基础设施》和《万方》数据库。纳入了报道CYP2C19多态性与卒中/TIA患者神经功能恶化之间关联的前瞻性队列研究。作者提取并汇总了风险比（RR）和95％置信区间（CI）的数据。遵循系统评价和荟萃分析指南的首选报告项目。
结果：纳入了12项符合条件的研究。12项研究报告了CYP2C19*2，*3个功能丧失等位基因，5项研究报告了CYP2C19*17个功能获得等位基因。与非运营商相比，CYP2C19*2，*3功能丧失等位基因的携带者具有显著较高的神经系统恶化风险(RR，1.63；95CI，1.32-2.02）。相反，CYP2C19*17功能获得等位基因的携带者神经系统恶化的风险显着降低（RR，0.520；95CI，0.393-0.689）与非运营商相比。
结论：该荟萃分析表明，与中风或TIA患者的非携带者相比，CYP2C19*2，*3功能丧失等位基因的携带者神经系统恶化的风险增加。此外,CYP2C19*17功能获得等位基因可以降低神经系统恶化的风险。
方法：PubMed，科克伦图书馆,摘录医学数据库，搜索了截至2019年4月发表的《中国国家知识基础设施》和《万方》数据库。纳入了报道CYP2C19多态性与卒中/TIA患者神经功能恶化之间关联的前瞻性队列研究。作者提取并汇总了风险比（RR）和95％置信区间（CI）的数据。遵循系统评价和荟萃分析指南的首选报告项目。
结果：纳入了12项符合条件的研究。12项研究报告了CYP2C19*2，*3个功能丧失等位基因，5项研究报告了CYP2C19*17个功能获得等位基因。与非运营商相比，CYP2C19*2，*3功能丧失等位基因的携带者具有显著较高的神经系统恶化风险(RR，1.63；95CI，1.32-2.02）。相反，CYP2C19*17功能获得等位基因的携带者神经系统恶化的风险显着降低（RR，0.520；95CI，0.393-0.689）与非运营商相比。
结论：该荟萃分析表明，与中风或TIA患者的非携带者相比，CYP2C19*2，*3功能丧失等位基因的携带者神经系统恶化的风险增加。此外,CYP2C19*17功能获得等位基因可以降低神经系统恶化的风险。
