缺血性青年脑卒中脑动脉狭窄与血浆HCY水平及MTHFR C677T基因多态性的相关性研究  

Correlation between cerebral artery stenosis,plasma HCY level and MTHFR C677T gene polymorphism in ischemic young stroke patients

作　　者：曹庆阳 高宇[1] 宁志杰 孙婧 沈静 翟全花 南光贤[1] CAO Qingyang;GAO Yu;NING Zhijie(Department of Neurology,China-JapanUnion Hospital of Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院神经内科,吉林长春130033

出　　处：《中风与神经疾病杂志》2020年第3期237-241,共5页Journal of Apoplexy and Nervous Diseases

基　　金：吉林省人才开发资金资助专项课题(No.802160100430)。

摘　　要：目的研究缺血性青年脑卒中脑动脉狭窄与同型半胱氨酸(HCY)的水平及亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性的关系。方法在吉林大学中日联谊医院神经内科二病区随机选取缺血性青年脑卒中的住院患者50例,其中符合纳入标准的41例,根据有无脑血管狭窄分为狭窄组(20例)及非狭窄组(21例),分别对其血浆HCY的水平及MTHFR C677T基因多态性进行测定并进行统计学分析。结果在41例患者中HCY的水平CC基因型(10.61±2.66)μmol/L低于TT基因型(19.65±14.43)μmol/L(P=0.033)及CT+TT基因型(16.65±12.48)μmol/L(P=0.015)。脑动脉狭窄组与非狭窄组HCY的水平分别为(20.44±14.70)μmol/L、(11.03±4.40)μmol/L(P=0.012);其中狭窄组HCY的水平CC基因型(12.23±2.18)μmol/L低于TT基因型为(28.55±16.82)μmol/L(P=0.043)及CT+TT基因型(22.48±15.82)μmol/L(P=0.023);非狭窄组的HCY水平CC基因型(8.46±1.40)μmol/L低于TT基因型为(11.86±5.0)μmol/L(P=0.161)及CC+TT基因型(11.46±4.60)μmol/L(P=0.048);两组同一基因型HCY的水平TT基因型分别为(28.55±16.82)μmol/L、(11.86±5.02)μmol/L(P=0.040),CC基因型分别为(12.23±2.18)μmol/L,(8.46±1.40)μmol/L(P=0.049),CT基因型分别为(17.77±14.12)μmol/L、(11.14±4.48)μmol/L(P=0.178)。两组MTHFR C677T的TT、CT、CT+TT基因型分别与CC基因型比较P>0.05,T与C等位基因比较P>0.05;Logistic回归分析可知HCY(OR=1.168、95%CI 1.015~1.344、P=0.030)是脑血管狭窄的危险因素。结论HCY的水平是缺血性青年脑卒中患者脑动脉狭窄的高危因素。MTHFR C677T的TT基因型是影响血浆HCY水平的关键因素,但C677T基因型及等位基因频率与脑动脉狭窄无直接的相关性。Objective To study the relationship between cerebral artery stenosis and homocysteine(HCY)level and methylenetetrahydrofolate reductase(MTHFR)C677T gene polymorphism in ischemic youth stroke.Methods 50 patients with ischemic young stroke were randomly selected from department 2 of neurology,China-Japan Union Hospital of Jilin University,41 of whom met the inclusion criteria.They were divided into stenosis group(20 cases)and non-stenosis group(21 cases)according to the presence or absence of cerebrovascular stenosis.The plasma HCY level and MTHFR C677T gene polymorphism were measured and analyzed statistically.Results In 41 patients,HCY level CC genotype(10.61±2.66)μmol/L was lower than TT genotype(19.65±14.43)μmol/L(P=0.033)and CT+TT genotype(16.65±12.48)μmol/L(P=0.015).HCY levels in cerebral artery stenosis group and non-stenosis group were(20.44±14.70)μmol/L,(11.03±4.40)μmol/L(P=0.012)respectively(P=0.012).The level CC genotype 12.23±2.18μmol/Lof HCY in stenosis group was lower than TT genotype(28.55±16.82)μmol/L(P=0.043)and CT+TT genotype(22.48±15.82)μmol/L(P=0.023).The HCY level of CC genotype(8.46±1.40)μmol/L in non-stenosis group was lower than that of TT genotype(11.86±5.0)μmol/L(P=0.161)and CC+TT genotype(11.46±4.60)μmol/L(P=0.048).The level of the same genotype HCY in the two groups was(28.55±16.82)μmol/L,(11.86±5.02)μmol/L(P=0.040),the CC genotype was(12.23±2.18)μmol/L,(8.46±1.40)μmol/L(P=0.049),and the CT genotype was(17.77±14.12)μmol/L,(11.14±4.48)μmol/L(P=0.178).TT,CT and CT+TT genotypes of MTHFR C677T in the two groups were respectively compared with CC genotype P>0.05,and T was compared with C allele P>0.05.Logistic regression analysis showed that HCY(OR=1.168,95%CI 1.015~1.344,P=0.030)was a risk factor for cerebrovascular stenosis.Conclusion The level of HCY is a high risk factor for cerebral artery stenosis in ischemic young stroke patients.TT genotype of MTHFR C677T is the key factor affecting plasma HCY level,but C677T genotype and allele frequency have no dire

关 键 词：缺血性青年脑卒中 脑动脉狭窄 HCY C677T 基因多态性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]