颅内动脉狭窄斑块与雌激素受体αA基因甲基化和tHcy变化的研究  

Hypermethylation of Estrogen-αA Receptor Gene and Total Homocysteine in Stenosis of the Intracranial Artery

作　　者：刘松 孙洪英[1] 贺淑慧[2] 宋瑞琦 傅增辉 温萍萍 渠泽平 雍雯 LIU Song;SUN Hongying;HE Shuhui(The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014010,P.R.China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院,包头014010 [2]内蒙古包头医学院,014040

出　　处：《临床放射学杂志》2019年第5期778-782,共5页Journal of Clinical Radiology

基　　金：包头医学院科学研究基金项目资助(编号:BYJJ-QM2016114)

摘　　要：目的探讨颅内动脉狭窄斑块的性质与分子生物学的关系,及其与缺血性卒中发病机制的关系。方法搜集2015年9月至2017年7月本院69例存在颅内动脉狭窄且有神经系统缺损症状的患者,经磁共振扩散加权成像(DWI)证实同侧颅内动脉供血区急性缺血性脑卒中,以大脑中动脉(MCA)为例,对狭窄段进行高分辨率磁共振成像(HRMRI),观察斑块的位置及DWI高信号的分布情况,分析斑块分布特征及其引起缺血性卒中的机制是否存在差异。检测静脉血雌激素αA受体(ERαA)基因甲基化状态及mRNA表达水平,分析不同信号斑块是否存在差异。结果 HRMRI清楚地显示MCA狭窄段管壁结构,69例患者分为不稳定斑块组和稳定斑块组,共83处狭窄斑块,上壁斑块29处(35.8%),下壁斑块23处(28.4%),腹侧壁斑块15处(18.5%),背侧壁斑块16处(17.3%);偏心性斑块68例(85.0%),向心性斑块1例(15.0%)。责任血管斑块的分布与梗死面积相关(χ~2=13.7,P<0.05),比较两组狭窄率、吸烟、高同型半胱氨酸(HHcy)、高密度脂蛋白胆固醇(HDL-C)及甲基化有统计学意义(P<0.05)。不稳定斑块组ERαA基因mRNA表达缺失率是稳定斑块组的2.4倍(P<0.05)。同时,不稳定斑块组同型半胱氨酸(tHcy)水平显著高于稳定斑块组(P<0.05),ERαA基因甲基化程度与tHcy相关系数r=0.549。结论不稳定性斑块更易引起颅内动脉狭窄及急性缺血性脑血管事件的发生,可能与其不稳定性有关。责任动脉粥样硬化斑块的不同分布可能与梗死面积有关。ERαA甲基化和tHcy升高可能与颅内动脉狭窄斑块不稳定性的形成相关。Objective To discuss the methylation state in ERαA gene promoter region in molecular biology and its relation to intracranial arterial stenotic plaque and to explore this relationship with the distribution of plaque in the mechanism of ischemic stroke. Methods From September 2015 to July 2017,69 patients with intracranial arterial stenosis and neurologic deficits were collected,and those with acute ischemic stroke in the ipsilateral intracranial arterial blood supply were confirmed by diffusion-weighted magnetic resonance imaging(DWI). Then taking the middle cerebral artery(MCA) as an example,high-resolution magnetic resonance imaging(HR-MRI) was performed on the stenotic segment to observe the location of the plaque and the distribution of DWI hyperintense signals,and to analyze the distribution of plaque and whether there is a difference in mechanisms responsible for ischemic stroke. Methylation status and mRNA expression levels in the promoter regions of venous blood are detected to analyze whether there is a difference in signal plaques. Results HR-MRI showed the wall structure of the middle cerebral artery stenotic segment clearly. There were 83 stenotic plaques in 69 patients,29 cases with upper wall plaque(35.8%),and 23 cases with lower wall plaque(28.4%),15 cases with abdominal wall plaques(18.5%),16 cases with back wall plaques(17.3%),68 cases with centrifugal plaques(85.0%),and 1 case with centripetal wall plaques(15.0%). Moreover,it was found that the distribution of atherosclerotic plaque was related to the type of infarction(χ~2=13.7,P<0.05). The infarct size,stenosis rate,smoking,HHcy,HDL-C,and methylation in the two groups were statistically significant(P<0.05). The mRNA expression loss frequency of ERαA gene in the unstable plaque group was 2.4 times that in the stable plaque group(P<0.05),with statistical significance(P<0.05). At the same time,the level of tHcy in the unstable plaque group was significantly higher than that in the control group(P<0.05). The correlation coefficient between the

关 键 词：雌激素受体αA 甲基化 颅内动脉狭窄 高分辨率磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]