ABCB1基因C3435T多态性与中国汉族缺血性卒中患者抗血小板药反应性的相关性  

Correlation between C3435T polymorphism of ABCB1 gene and response to anliplatelet drugs in Chinese Han patients with ischemic stroke

作　　者：王召月 王雁[1] 脱淼[1] 隋爱华[1] 

机构地区：[1]青岛大学附属医院神经内科,266021

出　　处：《国际脑血管病杂志》2017年第12期1096-1100,共5页International Journal of Cerebrovascular Diseases

基　　金：青岛市民生科技项目（15-9-2-92-nsh）

摘　　要：目的探讨多药耐药基因ABCB1 C3435T多态性与中国汉族缺血性卒中患者抗血小板药反应性的相关性。 方法连续纳入住院治疗的非心源性栓塞性缺血性卒中患者，根据血栓弹力图检测结果分为抗血小板药反应良好组和反应不良组。采用聚合酶链反应－限制性片段长度多态性技术进行ABCB1基因C3435T多态性检测。采用多变量logistic回归分析确定缺血性卒中患者抗血小板药反应不良的独立危险因素。 结果共纳入260例缺血性卒中患者，其中男性173例（66.5%），女性87例（33.5%）；抗血小板药反应良好193例（74.2%），反应不良67例（25.8%）。反应良好组年龄较轻，男性多见，而且吸烟比例和三酰甘油水平显著更高（P均〈0.05）。反应不良组TT基因型和T等位基因频率显著高于反应良好组（P均〈0.05）。多变量logistic回归分析显示，在校正相关混杂因素后，三酰甘油（优势比1.045，95%可信区间1.011～2.010；P＝0.014）和C3435T TT基因型（优势比1.512，95%可信区间1.013～2.256；P＝0.043）是抗血小板药反应不良的独立危险因素。 结论C3435T TT基因型为中国汉族缺血性卒中患者抗血小板药反应不良的独立危险因素。ObjectiveTo investigate the correlation between multidrug resistance gene ABCB1 C3435T polymorphism and antiplatelet drug reactivity in Chinese Han patients with ischemic stroke. MethodsConsecutive inpatients with non-cardiogenic embolic ischemic stroke were enrolled. They were divided into a good response to antiplatelet drug group and poor response to antiplatelet drug group according to the results of thrombelastogram. Polymerase chain reaction-restriction fragment length polymorphism technique was use to detect the C3435T polymorphism of ABCB1 gene. Multivariate logistic regression analysis was used to determine the independent risk factors for poor response to antiplatelet drugs in patients with ischemic stroke. ResultsA total of 260 patients with ischemic stroke were enrolled, including 87 females （33.5%） and 173 males （66.5%）. There were 193 patients （74.2%） in the good response group and 67 （25.8%）in the poor response group. The age was younger and male was more common in the good response group, and the proportions of smoking and triacylglycerol level were significantly higher （all P〈0.05）. The frequencies of TT genotype and T allele of the poor response group were significantly higher than those of the good response group （all P〈0.05）. Multivariable logistic regression analysis showed that triacylglycerol （odds ratio 1.045, 95% confidence interval 1.011-2.010; P=0.014） and C3435T TT genotype （odds ratio 1.512, 95% confidence interval 1.013-2.256; P=0.043） were the independent risk factors for poor response to antiplatelet drugs after adjusting confounding factors. ConclusionThe C3435T TT genotype is an independent risk factor for poor response to antiplatelet drugs in Chinese Han patients with ischemic stroke.

关 键 词：卒中 脑缺血 ATP结合盒蛋白 B亚族 成员1 多态现象 单核苷酸 阿司匹林 抗药性 血小板功能试验 氯吡格雷 

分 类 号：R743.3[医药卫生—神经病学与精神病学]