COMT 基因多态性和抗精神分裂症药物疗效关系的Meta 分析

目的：探讨儿茶酚胺氧位甲基转移酶(catechol O-methyltransferase，COMT)Val108/158 Met基因多态性与抗精神分裂症药物疗效之间的关系，为抗精神分裂症药物的个体化用药提供一定的依据。方法：计算机检索PubMed，Embase，Cochrane Library，中国知网，万方，维普，中国生物医学文献数据库获取相关文献。在评价原始研究质量，提取有效数据后，采用Stata12.0进行统计分析。结果：共筛选出9篇符合标准的文献，包含868例患者。Meta分析结果显示各基因型合并后的RR值、95% CI及P值，以患者的总体症状改善情况来评价药物疗效时，Met与Val比较，RR=1.18，95% CI：1.04~1.35，P=0.013；Met/Met与Val/Val比较，RR=1.40，95% CI：1.08~1.82，P=0.010。以患者的阴性症状改善情况来评价药物疗效时，Met与Val比较，RR=1.24，95% CI：1.05~1.46，P=0.013；Met/Met与Val/Val比较，RR=1.60，95% CI：1.04~2.46，P=0.031。结论：COMT Val108/158Met基因多态性与抗精神分裂症药物疗效显著相关，其中Met基因为优势基因，对抗精神分裂症药物反应较好。

COMT genetic variation and clinical response to antipsychotic drug treatment: A Meta-analysis

Objective: To examine the relationship between COMT polymorphisms and the response toantipsychotic drugs, and then provide a basis for personalized medicine of antipsychotic drugs.Methods: We performed a systematic search from PubMed, Embase, Cochrane Library, CBM,CNKI, VIP and Wanfang database for eligible studies. Stata 12.0 was used for Meta-analysis afterevaluating the quality of studies and collecting the data.Results: Nine studies included 868 participants met inclusion criteria. Significant association wasfound between the COMT Val108/158Met gene polymorphism and antipsychotic drug efficacy.Evaluating the therapeutic efficacy through general symptoms: Met vs Val, RR=1.18, 95% CI:1.04-1.35, P=0.013; Met/Met vs Val/Val, RR=1.40, 95% CI: 1.08-1.82, P=0.010. Evaluatingthe therapeutic efficacy through negative symptoms: Met vs Val, RR=1.24, 95% CI: 1.05-1.46,P=0.013; Met/Met vs Val/Val, RR=1.60, 95% CI: 1.04-2.46, P=0.031.Conclusion: COMT Val108/158Met gene polymorphism is significantly associated withantipsychotic drug efficacy, and Met gene is a dominant gene which displays a better response toantipsychotic drugs.