MTHFR C677T基因多态性与颈动脉狭窄及其侧支循环形成的关系  

Relationship between the MTHFR C677T Gene Polymorphism and the Collateral Circulation in Patients with Carotid Stenosis

作　　者：张立亚[1] 鲍娟[1] 王家平[1] 曹毅[1] 景睿[1] 张磊[1] 张文卿 李天祎 ZHANG Liya;BAO Juan;WANG Jiaping;CAO Yi;JING Ri;ZHANG Lei;ZHANG Wenqing;LI Tianyi(The Sencond Affiliated Hospital,Kun Ming Medical University,Kunming,Yunnan Province 650101,China)

机构地区：[1]昆明医科大学第二附属医院脑血管病科,云南昆明650101

出　　处：《昆明医科大学学报》2022年第2期96-101,共6页Journal of Kunming Medical University

基　　金：昆明医科大学第二附属医院院内科技计划项目(2018yk009);云南省中青年学术和技术带头人后备人才资助项目(701170214)。

摘　　要：目的研究MTHFR C677T基因多态性与颈动脉狭窄及其侧支循环形成的关系。方法收集2018年10月至2021年3月昆明医科大学第二附属医院脑血管病科通过DSA诊断颈动脉中重度狭窄或慢性闭塞的患者65例,无明显颈动脉狭窄的对照组45例。所有患者完成一般情况评估。颈动脉中重度狭窄或慢性闭塞的65例患者DSA ASITN评分评估侧支循环分级。所有患者完成MTHFR C677T基因多态性检测。结果颈动脉中重度狭窄及慢性闭塞的患者既往卒中发生率显著高于对照组。颈动脉中重度狭窄及慢性闭塞组的年龄、吸烟史、高血压、糖尿病史、总胆固醇、低密度胆固醇脂蛋白、同型半胱氨酸及MTHFR C677T基因CT/TT型占比差异有统计学意义(P<0.05)。在中重度颈动脉狭窄或慢性颈动脉闭塞患者中,侧支循环开放良好者(3~4级)CC型所占比例高于TT/CT型,而侧支循环开放不良(1-2级)者TT/TC型较多,组间比较差异有显著性意义(P<0.05)。结论MTHFR基因CT/TT型是颈动脉狭窄的危险因素。较CC型,CT/TT型颈动脉狭窄患者侧支循环开放更差。Objective To study the relationship between the MTHFR C677T gene polymorphism and the collateral circulation in patients with carotid stenosis.Methods A total of 65 patients with moderate or severe carotid stenosis and chronic occlusion diagnosed by DSA and 45 controls without carotid stenosis from October 2018 to March 2021 in our hospital were included.All patients completed general assessment.65 patients with moderate or severe carotid stenosis and chronic occlusion were evaluated the collateral circulation ASITN grading by DSA.All patients completed MTHFR C677T genetic polymorphism test.Results The incidence of stroke in patients with moderate or severe carotid stenosis and chronic occlusion was significantly higher than that in control group.There were significant differences in age,smoking history,hypertension,diabetes,total cholesterol,low density cholesterol lipoprotein,homocysteine and CT/TT type of MTHFR C677T gene between carotid artery stenosis or chronic occlusion group and control group(P<0.05).The patients with good collateral circulation(ASITN grade 3-4)had high proportion of CC type in moderate or severe carotid stenosis and chronic carotid occlusion group.And the TT/TC type were more in patients with poor collateral circulation opening(ASITN grade 1-2).Conclusions CT/TT type of MTHFR genotype is a risk factor for carotid stenosis.The collateral circulation of patients with CT/TT type is worse comparing with CC type in carotid stenosis.

关 键 词：颈动脉狭窄 MTHFR C677T基因多态性 侧支循环 

分 类 号：R743[医药卫生—神经病学与精神病学]