MTHFR C677T基因多态性与脑出血后周围水肿的关系  

Relationship between MTHFR C677T gene polymorphism and peripheral edema after cerebral hemorrhage

作　　者：牛瑞娜[1] 耿迪 郭艳丽[1] 邓文静[1] NIU Ruina;GENG Di;GUO Yanli(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院神经内科,450000 [2]郑州大学第一附属医院肿瘤科,450000

出　　处：《临床神经病学杂志》2025年第1期32-37,共6页Journal of Clinical Neurology

摘　　要：目的探讨MTHFR C677T基因多态性与脑出血后周围水肿的关系。方法根据是否发生脑水肿扩大,将216例高血压脑出血患者分为水肿扩大组及水肿未扩大组。收集患者的临床资料,并检测患者的MTHFR C677T基因型。结果水肿扩大组同型半胱氨酸(Hcy)水平、入院72 h血管内皮生长因子(VEGF)水平、出血量和下肢静脉血栓发生率显著高于水肿未扩大组(P<0.05~0.01)。水肿扩大组MTHFR基因C677T位点TT基因型频率显著高于CT基因型,CT基因型频率显著高于CC组(均P<0.05)。水肿扩大组及水肿未扩大组MTHFR C677T基因型及等位基因频率差异有统计学意义(χ^(2)=70.668,P<0.001;χ^(2)=84.139,P<0.001)。多因素Logistic回归分析显示,入院72 h VEGF水平、MTHFR C677T位点CT基因型及TT基因型是脑出血水肿扩大的独立危险因素(OR=1.013,95%CI:1.007~1.019,P<0.001;OR=5.534,95%CI:2.426~12.625,P<0.001;OR=33.088,95%CI:9.012~121.479,P<0.001)。校正其他因素后,MTHFR C677CT与MTHFR C677CC的OR为5.53(95%CI:2.426~12.625,P<0.05),MTHFR C677TT与MTHFR C677CC的OR为33.09(95%CI:9.012~121.479,P<0.05)。MTHFR C677T位点TT基因型、CT基因型及CC基因型的水肿增长率差异有统计学意义(F=3.204,P=0.044)。MTHFR C677T位点TT基因型、CT基因型及CC基因型入院时VEGF水平差异无统计学意义(F=0.978,P=0.379),入院72 h VEGF水平差异有统计学意义(F=5.819,P=0.007)。结论MTHFR C677T基因多态性与脑出血后继发水肿扩大有关。Objective To investigate the relationship between MTHFR C677T gene polymorphism and peripheral edema after intracerebral hemorrhage.Methods Two hundred and sixteen patients with hypertensive intracerebral hemorrhage were divided into edema enlargement group and edema non-enlargement group according to whether cerebral edema enlargement occurred.Clinical data of the patients were collected,and the MTHFR C677T genotype was detected.Results The level of homocysteine(Hcy),vascular endothelial growth factor(VEGF)level at 72 h after admission,blood loss and incidence of venous thrombosis of lower extremity in edema enlargement group were significantly increased than those in edema non-enlargement group(P<0.05-0.01).The frequency of TT genotype of MTHFR C677T in edema enlargement group was significantly higher than that of CT genotype,and the frequency of CT genotype was significantly higher than that of the frequency of CC genotype(all P<0.05).There were significant differences in MTHFR C677T genotype and allele frequency between edema enlargement group and edema non-enlargement group(χ^(2)=70.668,P<0.001;χ^(2)=84.139,P<0.001).Multivariate Logistic regression analysis showed that VEGF level at 72 h after admission,MTHFR C677T CT genotype and TT genotype were independent risk factors for cerebral hemorrhage edema enlargement(OR=1.013,95%CI:1.007-1.019,P<0.001;OR=5.534,95%CI:2.426-12.625,P<0.001;OR=33.088,95%CI:9.012-121.479,P<0.001).After adjusting for other factors,the OR of MTHFR C677CT to MTHFR C677CC was 5.53(95%CI:2.426-12.625,P<0.05),and the OR of MTHFR C677TT to MTHFR C677CC was 33.09(95%CI:9.012-121.479,P<0.05).The edema growth rate of TT genotype,CT genotype and CC genotype at MTHFR C677T site was significantly different(F=3.204,P=0.044).There was no significant difference in VEGF level among TT genotype,CT genotype and CC genotype of MTHFR C677T site at admission(F=0.978,P=0.379),but there was significant difference in VEGF level at 72 h after admission(F=5.819,P=0.007).Conclusion MTHFR C677T gene polymorphi

关 键 词：MTHFR C677T基因多态性 脑出血 水肿 

分 类 号：R743.34[医药卫生—神经病学与精神病学]