缺血性脑卒中患者吸烟与热休克蛋白70-1变异的交互作用

Interaction between mutation of heat stress protein 70-1 and tobacco smoking in cerebral arterial thrombosis

目的探讨热休克蛋白(HSP)70-1基因190G/C变异与吸烟之间交互作用在缺血性脑卒中发生的意义。方法采用11配比的病例对照研究设计,选择深圳市两家综合性医院经头部CT、MRI检查确诊的缺血性脑卒中新发病例(n=116)为病例组,同时选择按年龄、性别匹配健康者作为对照组。对2组人群进行问卷,采用聚合酶链反应-限制性片断长度多态性(PCR-RFLP)方法检测HSP70-1多态性,运用相加模型分析HSP70-1变异与吸烟的交互作用。结果HSP70-1变异与吸烟之间对缺血性脑卒中患病具有正交互作用,归因交互效应9.63,交互效应百分比39.56%,纯因子间归因交互效应百分比41.26%,交互作用指数1.70;用多元条件Logistic回归模型调整饮酒,高血压、饮茶,腰臀比后,HSP70-1变异与吸烟之间仍具有正交互作用,归因交互效应2.78,交互效应百分比17.90%,交互作用指数1.24。结论HSP70-1变异可增加吸烟者缺血性脑卒中的发病的危险性,可以通过对HSP70-1变异与吸烟同时存在的这部分人群中控制吸烟可明显降低人群中缺血性脑卒中的发病风险。

Objective To explore the interaction between heat stress protein （HSP）70-1 gene mutation and tobacco smoking in cerebral arterial thrombosis. Methods A 1 ： 1 matched case-control study was performed. 116 patients with onset ischemic stroke were selected from two general hospitals in Shenzhen. The controls were selected by the same gender and ethnic group, and each pair＇s ages were permitted to differ within 5 years. HSP70- 1 genotypes were analyzed by using the polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） technique. The cases and controls were interviewed using the same questionnaire. Additive model was applied to analyze the interaction. Results There was positive interaction between HSP70-1 mutation and tobacco smoking in patients with cerebral arterial thrombosis. Attributable interaction was 9.63. Attributable interaction percent was 39.56. Pure attributable interaction percent was 41.26 and interaction index was 1.70. After adjusting alcohol drinking, hypertension history and tea drinking by condition logistic regression model, positive interaction was also observed. Attributable interaction, attributable interaction percent and interaction index were 2.78, 17.90% , and 1.24 respectively. Conclusion HSP70-1 gene 190G/C mutation can greatly increase the risk of ischemic stroke in tobacco smoking populations. To control the smoking in the population who had HSP70-1 mutation and smoking simultaneously would reduce remarkably occurrences of the ischemic stroke in general populations.