VEGF单核苷酸多态性与自发性蛛网膜下腔出血后脑血管痉挛发生的相关性研究

Study on Associations of vascular endothelial growth factor single nucleotide polymorphisms with the CVS after Spontaneous SAH

目的探讨血管内皮生长因子（vasculax endothelial growth factor，VEGF）单核苷酸多态性（single—nucleotide polymorphisms，SNPs）与白发性蛛网膜下腔出血（subarachnoid hemorrhage，SAH）后脑血管痉挛（cerebral vasospasm，CVS）的相关性。方法经临床确诊SAH患者189例，采用TCD检测和评定SAH患者CVS情况，分为CVS（-）组96例和CVS（＋）组93例，另选健康对照组120名，采用聚合酶链反应限制性片段长度多态性（PCR—RFLP）方法检测VEGF＋405G／C，-460C／T和＋936C／T位点的基因型及等位基因分布频率，分型结果与临床资料等分别采用SPSS17．0软件进行x^2检验和Logistic回归分析。结果脑血管痉挛与＋405G／C和＋936C／T位点基因型及等位基因频率间关系无统计学意义；脑血管痉挛与-460C／T位点基因型及等位基因分布间关系具有统计学意义；进一步调整相关临床资料，单因素和多因素Logistic回归分析均提示-460TT是脑血管痉挛的危险因素（OR=2．323，P=0．0012，95％C11．398～3．862），此外，年龄及Hunt—Hess分级也为脑血管痉挛的危险因素。结论在本研究的中国人群中，VEGF-460T／T多态性为脑血管痉挛的危险因素，但并非独立危险因素。

Objective To investigate the influence of the vascular endothelial growth factor（VEGF） single nucleotide polymorphisms （SNPs） on cerebral vasospasm （CVS） after spontaneous subarachnoid hemorrhage （SAH）. Methods 189 patients with spontaneous SAH ,use of transcranial doppler （TCD） monitoring and assessment CVS situation of patients with SAH, Three single-nucleotide polymorphisms, ＋ 405G/C, -460C/T and ＋ 936C/T of the VEGF gene, were genotyped in 96 SAH patients without CVS ,93 CVS patients after SAH and 120 healthy controls by using the polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） method. x2 test and logistic regression analysis were performed with SPSS version 17.0. Results There were no statistically significant differences between CVS patients and Polymorphic of ＋ 405G/C and ＋ 936C/T. The frequency of the -460C/T genotype was significantly differences in patients with CVS（ ＋ ） group as compared to CVS（ - ） group and controls （P 〈0. 05）. but after adjusting for patient age, hypertension and Hunt-Hess grade etc. , Logistic regression analysis showed that -460TT was a risk factor（ OR = 2. 323, P = 0. 0012, 95% CI 1. 398 -3. 862） to CVS patients, Patient age, and Hunt-Hess grade were also risk factors. Conclusions In the Chinese population, our findings indicated that - 460TT alleles confer significant risk factor of CVS, but not an independent risk factor. This may contribute to poor prognosis after CVS.