环氧化酶2基因多态性与大动脉粥样硬化型脑梗死患者预后的相关研究  

Relationship between cyclooxygenase 2 gene polymorphism and clinical outcome in atherosclerosis ischemic stroke patients

作　　者：曹立平[1,2] 张治中[1,2] 张雨蒙[1,2] 白文[1,2] 孙文珊[1,2] 李松[1,2] 段作伟[1,2] 刘新峰[1,2] 徐格林[1,2] 

机构地区：[1]南方医科大学南京临床学院 [2]南京军区南京总医院神经内科,210002

出　　处：《中华老年心脑血管病杂志》2014年第1期50-53,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81220108008;81070922);江苏省自然科学基金(BK2011021)

摘　　要：目的 探讨环氧化酶2 （COX-2）基因rs20417和rs5275 2个位点多态性与服用阿司匹林治疗的大动脉粥样硬化型脑梗死患者临床预后的相关性.方法 入选南京卒中注册系统中2009年12月~2012年10月确诊为大动脉粥样硬化型脑梗死、并长期服用阿司匹林的患者962例.应用改进的多重连接酶检测反应技术分析COX-2基因2个位点的基因型.平均随访（15.13±7.42）个月,记录主要终点事件.结果 rs20417和rs5275最小等位基因频率分别为5.1%、19.1%.随访期间,有89例（9.25%）发生主要终点事件.rs20417位点CC＋CG型与GG型主要终点事件发生率比较,差异无统计学意义（HR=0.92,95%CI：0.44~1.89,P=0.81）.rs5275位点AA型与AG＋GG型主要终点事件发生率比较,差异无统计学意义（HR=1.17,95%CI：0.76~1.79,P=0.48）.多因素Cox风险比例模型分析,男性患者预后较好,rs20417 C等位基因和rs5275 G等位基因携带者与预后不相关（P〉0.05）.结论 COX-2基因 rs20417和rs5275位点多态性可能与大动脉粥样硬化型脑梗死患者临床预后无关.Objective To study the relationship between the polymorphism of cyclooxygenase 2 （COX-2） gene and the clinical outcome in atherosclerosis ischemic stroke patients on aspirin ther- apy. Methods Nine hundred and sixty-two atherosclerosis isehemie stroke patients on long-term aspirin therapy registered in the Nanjing Stroke Registry System were included in this study. Gen- otypes of COX-2 rs20417 and rs5275 polymorphism were analyzed by improved multiplex ligase detection reaction. The patients were followed up for an average time of 15.13±7.42 months. Re- sults The minor allele frequency of rs20417 and rs5275 was 5.1% and 19.1%0 ,respectively. Ma- jor endpoint events occurred in 89 patients （9.25G） during the follow-up period. No significant difference in the incidence of primary endpoints was found for rs20417 genotypes （CC＋CG vs GG,P=0.81） and rs5275 genotypes （AG＋GG vs AA,P=0.48）. Multivariate Cox proportional hazard model analysis showed that the clinical outcome was better in male patients than in female patients with no significant difference observed in the clinical outcome between rs20417 C and rs5275 G carriers （P〈0. 05）. Conclusion The polymorphism of rs20417 and rs5275 in COX-2 gene may not be related with the clinical outcome in atherosclerosis ischemic stroke patients.

关 键 词：脑梗死 环氧化酶2 基因型 动脉粥样硬化 阿司匹林 基因频率 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]