亚甲基四氢叶酸还原酶基因多态性与不同临床类型血管性痴呆及血浆Hcy水平的相关性  

Correlation of methylenetetrahydrofolate reductase gene polymorphisms with different clinical types of vascular dementia and plasma Hcy levels

作　　者：陈世保 王平[1] 贾向军 吴新山 杜叶 关玉华[1] CHEN Shi-bao;WANG Ping;JIA Xiang-jun(Department of Neurology,Bayingolin Mongol Autonomous Prefecture People’s Hospital,Korla 841000,China)

机构地区：[1]新疆巴音郭楞蒙古自治州人民医院神经内科,841000

出　　处：《中国实用医药》2021年第31期195-198,共4页China Practical Medicine

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(项目编号:WJWY-201955),项目名称:《亚甲基四氢叶酸还原酶C677T基因多态性与不同类型血管性痴呆的相关性研究及长期随访》。

摘　　要：目的 探讨亚甲基四氢叶酸还原酶(MTHFR)基因多态性与不同临床类型血管性痴呆(VD)及血浆同型半胱氨酸(Hcy)水平的相关性。方法 选取90例VD患者作为观察组,另选取90例体检健康者作为对照组。观察组依据疾病分型分为多梗死性痴呆(MID)组、关键部位梗死性痴呆(SID)组、皮质下血管性痴呆(SVD)组,各30例。对患者MTHFR C677T基因多态性、叶酸、维生素B12水平进行检测。比较对照组和观察组中MTHFR C677T各基因型、等位基因分布情况以及血浆Hcy、叶酸和维生素B12水平;比较对照组与观察组不同疾病分型患者MTHFR C677T基因型分布与血浆Hcy水平,MID组、SID组、SVD组不同MTHFR C677T基因型的血浆Hcy水平。结果 观察组Hcy(25.97±5.26)μmol/L高于对照组的(13.12±2.93)μmol/L,叶酸(6.46±1.32)ng/ml、维生素B12(346.70±21.33)pg/ml低于对照组的(8.31±2.01)ng/ml、(407.76±30.12)pg/ml,差异有统计学意义(P<0.05)。Pearson相关性分析显示,观察组中血浆Hcy水平与叶酸及维生素B12水平呈负相关(P<0.05)。对照组与MID组、SID组、SVD组的基因型分布情况比较差异无统计学意义(P>0.05);MID组T等位基因占比高于对照组,MID组、SID组、SVD组的Hcy水平高于对照组,差异具有统计学意义(P<0.05)。MID组中,携带TT型的患者血浆Hcy水平高于携带CC型及CT型的患者,携带CT型的患者血浆Hcy水平高于携带CC型的患者,差异有统计学意义(P<0.05)。SVD组中,携带TT型的患者血浆Hcy水平高于携带CC型及CT型的患者,差异有统计学意义(P<0.05)。结论 MTHFR基因多态性与血管痴呆的发病类型及血浆中Hcy水平密切相关,该基因的变化能够反应血管痴呆及血浆的变化状况。Objective To discuss the correlation of methylenetetrahydrofolate reductase(MTHFR)gene polymorphisms with different clinical types of vascular dementia(VD)and plasma homocysteine(Hcy)levels.Methods 90 patients with VD were selected as the observation group,and another 90 healthy subjects were selected as the control group.The observation group was divided into multi-infarct dementia(MID)group,strategic infarct dementia(SID)group,subcortical vascular dementia(SVD)group,with 30 cases in each group.The MTHFR C677T gene polymorphism,folic acid and vitamin B12 levels were detected in patients.Comparison was made on distribution of the genotypes and alleles of MTHFR C677T and the levels of plasma Hcy,folic acid and vitamin B12 between the control group and the observation group,and distribution of MTHFR C677T genotype and plasma Hcy levels in patients with different disease typing in the observation group and the control group,and plasma Hcy levels in different MTHFR C677T genotypes in the MID group,SID group and SVD group.Results Hcy(25.97±5.26)μmol/L in the observation group was higher than(13.12±2.93)μmol/L in the control group,and the folic acid(6.46±1.32)ng/ml and vitamin B12(346.70±21.33)pg/ml were lower than(8.31±2.01)ng/ml and(407.76±30.12)pg/ml in the control group.All the differences were statistically significant(P<0.05).Pearson correlation analysis showed a negative correlation between plasma Hcy levels and changes in plasma folate and vitamin B12 levels in the observation group(P<0.05).There was no statistically significant difference in the distribution of genotypes of the control group compared with the MID group,SID group,and SVD group(P>0.05).The proportion of T alleles in the MID group was higher than that of the control group,and the Hcy levels of the MID group,SID group and SVD group were higher than those of the control group.All the differences were statistically significant(P<0.05).In the MID group,the plasma Hcy level in patients carrying TT types were higher than those carrying CC type

关 键 词：亚甲基四氢叶酸还原酶基因多态性 血管性痴呆 血浆同型半胱氨酸 

分 类 号：R749.13[医药卫生—神经病学与精神病学]