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·循证药学·

基因多态性对侵袭性真菌感染患者伏立康唑血药浓度影响的
Meta分析 Δ

＊
李雅暄 ，李兴德，王国徽，毛盼盼，马雪娇，宋沧桑（昆明市第一人民医院药学部，昆明 650224）
#
中图分类号 R969.3；R978.5 文献标志码 A 文章编号 1001-0408（2025）02-0225-07
DOI 10.6039/j.issn.1001-0408.2025.02.16

摘 要 目的 评价基因多态性对侵袭性真菌感染患者伏立康唑（VRZ）血药谷浓度（cmin ）的影响。方法 检索the Cochrane Library、
Embase、PubMed、Web of Science、中国生物医学文献数据库、中国知网、维普网和万方数据，收集基因多态性与VRZ cmin相关的文
献，检索时间为建库至2024年4月。筛选文献，提取资料，评价文献质量后，使用R 4.3.2软件进行Meta分析。结果 共纳入21篇
文献，共计2 454例患者。Meta分析结果显示，CYP2C19 IM型、PM型患者的VRZ cmin均显著高于EM型，而IM型显著低于PM型
（P＜0.01）；CYP2C9 rs1057910 AA 型患者的 VRZ cmin显著高于 AC/CC 型，CYP3A5 rs776746 CC 型患者的 VRZ cmin显著高于 TT 型
（P＜0.01）；POR rs10954732 GG 型患者的 VRZ cmin显著高于 GA 型和 AA 型，POR rs1057868 CT 型患者的 VRZ cmin显著低于 TT 型
（P＜0.01）；ABCB1 rs1045642 CC型患者的VRZ cmin显著高于TT型（P＜0.05）；NR1I2 rs2472677 CT型患者的VRZ cmin显著高于TT
型，NR1I2 rs7643645 AA型患者的VRZ cmin显著高于AG型（P＜0.05）；ABCC2 rs717620 CC型患者的VRZ cmin均显著低于CT型和
TT 型，且 CT 型显著低于 TT 型（P＜0.01）。结论 CYP2C19、CYP2C9 rs1057910、CYP3A5 rs776746、POR rs10954732、ABCB1
rs1045642、NR1I2 rs7643645 突变等位基因均可导致 VRZ 血药浓度降低，ABCC2 rs717620 突变等位基因则可导致 VRZ 血药浓度
升高。
关键词 伏立康唑；侵袭性真菌感染；基因多态性；血药浓度；Meta分析

Meta-analysis of the effects of gene polymorphism on plasma concentration of voriconazole in patients with
invasive fungal infection
LI Yaxuan，LI Xingde，WANG Guohui，MAO Panpan，MA Xuejiao，SONG Cangsang（Dept. of Pharmacy，
Kunming First People’s Hospital， Kunming 650224， China）

ABSTRACT OBJECTIVE To evaluate the influence of gene polymorphism on plasma minimum concentration （cmin ） of
voriconazole （VRZ） in patients with invasive fungal infection. METHODS The Cochrane Library， Embase， PubMed， Web of
Science， China Biomedical Literature Database， CNKI， VIP and Wanfang Data were searched for literature on the correlation
between gene polymorphisms and cmin of VRZ from inception to April 2024. After screening the literature， extracting data， and
evaluating the quality of the literature， meta-analysis was performed using R 4.3.2 software. RESULTS A total of 21 studies with
2 454 patients were included. The results of meta-analysis showed that the VRZ cmin of CYP2C19 IM and PM types was significantly
higher than EM type， and the VRZ cmin of IM type was significantly lower than PM type （P＜0.01）. The VRZ cmin of CYP2C9
rs1057910 AA type was significantly higher than AC/CC type， and that of CYP3A5 rs776746 CC type was significantly higher than
TT type （P＜0.01）. The VRZ cmin of POR rs10954732 GG type was significantly higher than GA and AA types， and that of POR
rs1057868 CT type was significantly lower than TT type （P＜0.01）. The VRZ cmin of ABCB1 rs1045642 CC type was significantly
higher than TT type （P＜0.05）. The VRZ cmin of NR1I2 rs2472677 CT type was significantly higher than TT type， and rs7643645
AA type was significantly higher than AG type （P＜0.05）. The VRZ cmin of ABCC2 rs717620 CC type was significantly lower than
CT type and TT type， and the CT type was significantly lower than TT type （P＜0.01）. CONCLUSIONS Mutant alleles in
CYP2C19， CYP2C9 rs1057910， CYP3A5 rs776746， POR
Δ 基金项目 云 南 省 科 技 厅 重 大 科 技 专 项 计 划 项 目（No.
202302AA310018-C-3）；云南省卫生健康委员会医学领军人才培养项 rs10954732， ABCB1 rs1045642 and NR1I2 rs7643645 can
目（No.L-2018012）；云南省卫生健康委员会临床药学中心建设项目； lead to a decrease in VRZ plasma concentration， and mutant
昆明市医学科技领军人才培养项目［No.2023-SW（领军）-04］ allele in ABCC2 rs717620 can lead to an increase in VRZ
＊第一作者 药师，硕士研究生。研究方向：临床药学。E-mail：
plasma concentration.
1983378655@qq.com
# 通信作者 主任药师，硕士生导师。研究方向：临床药学和药 KEYWORDS voriconazole； invasive fungal infection； gene
物基因组学。E-mail：songcs163@163.com polymorphism； plasma concentration； meta-analysis

中国药房 2025年第36卷第2期 China Pharmacy 2025 Vol. 36 No. 2 · 225 ·