MTHFRC677T基因多态性对小剂量叶酸降低缺血性卒中患者同型半胱氨酸水平的影响  

Effect of MTHFRC677T gene polymorphism on homocysteine level reduced by low dose folic acid in patients with ischemic stroke

作　　者：居春阳 薛冰[1] 张会丽 赵海港 郑淼磊 吴斌[1] 齐连生 赵璐 JU Chunyang;XUE Bing;ZHANG Huili;ZHAO Haigang;ZHENG Miaolei;WU Bin;QI Liansheng;ZHAO Lu(Neurology Department,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China;Laboratory Department,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China)

机构地区：[1]河南科技大学附属许昌市中心医院神经内科,河南许昌461000 [2]河南科技大学附属许昌市中心医院检验科,河南许昌461000

出　　处：《临床医学研究与实践》2020年第32期63-65,共3页Clinical Research and Practice

摘　　要：目的观察亚甲基四氢叶酸还原酶C677T(MTHFRC677T)基因多态性对小剂量叶酸降低缺血性脑卒中患者同型半胱氨酸(Hcy)水平的影响。方法将355例缺血性脑卒中伴高同型半胱氨酸血症(HHcy)患者根据MTHFRC677T基因多态性分为A组(CC型,n=70)、B组(CT型,n=106)及C组(TT型,n=179),按照补充叶酸剂量0.4、0.8、1.2 mg/d将A、B、C组分为三个亚组:A1~A3、B1~B3、C1~C3。观察患者叶酸治疗前及治疗第7、15、30、90天Hcy水平,评价不同剂量叶酸降Hcy的疗效。结果335例患者中,C组基因型出现率最高,B组次之,A组最低。治疗第30、90天,B1亚组Hcy水平高于B2、B3亚组,C1亚组Hcy水平高于C2、C3亚组(P<0.05)。A组中各亚组降Hcy治疗均有效,组间比较,差异不显著(P>0.05)。B2、B3亚组治疗有效率高于B1亚组,C3亚组治疗有效率高于C1、C2亚组(P<0.05)。结论MTHFRC677T基因多态性显著影响缺血性脑卒中患者的Hcy水平,对优化小剂量叶酸降Hcy治疗有明确的指导意义。Objective To observe the effect of methylenetetrahydrofolate reductase C677T(MTHFRC677T)gene polymorphism on homocysteine(Hcy)level reduced by low dose folic acid in patients with ischemic stroke.Methods A total of 355 ischemic stroke patients with hyperhomocysteinemia(HHcy)were divided into group A(CC type,n=70),group B(CT type,n=106)and group C(TT type,n=179)according to MTHFRC677T gene polymorphism.According to the folic acid supplement dose of 0.4,0.8 and 1.2 mg/d,the patients of the group A,B,C were divided into three subgroups:A1-A3,B1-B3,C1-C3.The Hcy levels were observed before folate treatment and at 7,15,30,90 days of folate treatment,and the curativ effects of different doses of folic acid on reducing Hcy were evaluated.Results Among 335 patients,the genotype rate of the group C was the highest,followed by the group B,and the group A was the lowest.At 30 and 90 days of treatment,Hcy level in the B1 subgroup were higher than that in the B2 and B3 subgroups,Hcy level in the C1 subgroup were higher than that in the C2 and C3 subgroups(P<0.05).All subgroups in the group A were effective in reducing Hcy,and there was no significant difference between groups(P>0.05).The effective rates of treatment of the B2 and B3 subgroups were higher than that of the B1 subgroups,and the effective rate of treatment of the C3 subgroup were higher than that of the C1 and C2 subgroups(P<0.05).Conclusion MTHFRC677T gene polymorphism significantly affects Hcy level in patients with ischemic stroke,which has a clear guiding significance for optimizing low dose folic acid to reduce Hcy.

关 键 词：MTHFRC677T基因 基因多态性 高同型半胱氨酸血症 缺血性脑卒中 叶酸 

分 类 号：R774.1[医药卫生—眼科]