脑梗死患者COX-1及COX-2基因多态性与阿司匹林抵抗的相关性分析  

Association study of COX-1、COX-2 gene polymorphism and aspirin resistance in ischemic stroke patients

作　　者：李霞 王炜[2] 赵仕琪[2] 槐瑞雪 史肖鹤 李世平[2] 董梅[2] LI Xia;ZHAO Shiqi;HUAI Ruixue(Department of Neurology,Anhui No.2 Provincial People’s Hospital,Hefei 230000,China)

机构地区：[1]安徽省第二人民医院神经内科,安徽合肥230000 [2]河北医科大学第二医院神经内科,神经病学河北省重点实验室,河北石家庄050000

出　　处：《中风与神经疾病杂志》2019年第6期488-492,共5页Journal of Apoplexy and Nervous Diseases

基　　金：河北省重点基础研究项目(No.15967727D)

摘　　要：目的分析脑梗死患者COX-1-1676A>G、C50T、-A842G及COX-2-765G/C位点基因多态性与阿司匹林抵抗(AR)关系。方法选取首次发作急性脑梗死,规律服用阿司匹林(ASP)7d进行血栓弹力图(TEG)检测,分为阿司匹林抵抗组(AR,25例)和阿司匹林敏感组(AS,45例);对两组患者COX-1及COX-2基因共4个功能多态性位点测序,比较其基因型差异;完善患者生化指标、危险因素等临床资料,规律服用ASP并进行半年临床随访。结果70例患者中AS组为64.3%,AR组为35.7%;两组一般临床特征无差异(P>0.05);COX-1C50T、-A842G位点未见多态性,两组COX-1基因-1676A>G位点及COX-2基因-765G/C位点的基因型频率比较无差异(P>0.05);半年随访,终点事件发生率AR组脑梗死复发率较AS组增高(P<0.05);COX-2-765G/C及COX-1-1676A>G基因型与临床主要终点事件脑梗死复发进行比较无差异(P>0.05)。结论AR组脑梗死复发率高;AR组和AS组COX-1基因-A842G、C50T均未发现突变;COX-1-1676A>G与COX-2-765G/C基因型与AR、主要终点事件脑梗死复发间比较未发现明显相关性。Objective To analyze the relationship between COX-1-1676A>G,C50T,-A842G,and COX-2-765G/C polymorphisms and aspirin resistance in ischemic stroke patients.Methods Patients with acute ischemic stroke for the first time were divided into aspirin resistance group(AR)and aspirin sensitive group(AS)after taking aspirin for 7 days detected by TEG.Four single nucleotide polymorphisms of COX-1 and COX-2 gene were examined by PCR and the differences were compared in two groups.Biochemical indexes and risk factors were also collected.All the patients were follow-up for 6 months with regular aspirin.Results Among 70 cases,45(64.3%)were AS and 25(35.7%)were AR detected by TEG.There were no significant differences in clinical features and testing results between them.There were no significant differences in the genotype distribution of COX-1-A842G,C50T,-1676A>G,COX-2-765G/C between AR and AS group.During 6 months follow-up,the incidence of recurrent cerebral infarction was higher in AR than AS(P<0.05).There were no significant differences in the incidence of primary endpoint in patients with genotype of COX-1-1676A>G or COX-2-765G/C(P>0.05).Conclusion Patient in AR group had a high recurrence rate.Wild heterozygous and homozygous mutations were not found in COX-1-A842G and C50T among patients.No obvious correlations were found among rs1330344,rs20417 genotype,aspirin resistance and the recurrent of ischemic stroke.

关 键 词：脑梗死 阿司匹林抵抗 血栓弹力图 COX-1受体 COX-2受体 

分 类 号：R743.3[医药卫生—神经病学与精神病学]