缺血性脑卒中及不同亚型与血浆脂蛋白相关磷脂酶A2水平及其基因I198T多态性的关系

Relationship between ischemic stroke and its subtype with level of plasma lipoprotein-associated phospholipase A2 and its gene I198T polymorphism

目的研究缺血性脑卒中(IS)及不同亚型与血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平及Lp-PLA2基因I198T多态性的关系。方法 228例IS患者按急性卒中Orgl 10172治疗试验(TOAST)分型分为大动脉粥样硬化性脑卒中(LAA)组(123例)、小动脉闭塞性脑卒中(SAO)组(71例)和心源性栓塞(CE)组(34例)。采用酶联免疫吸附法(ELISA)测定血浆Lp-PLA2水平,应用PCR及基因直接测序法确定Lp-PLA2基因I198T位点的多态性;计算IS相对危险度。并与202名正常对照者比较。结果 IS组及其LAA亚组的血浆Lp-PLA2水平、Lp-PLA2基因I198T位点突变基因型、等位基因频率及其IS相对危险度均显著高于正常对照组(P<0.01～0.001);SAO和CE亚组以上指标与正常对照组的差异均无统计学意义。各组不同基因型之间血浆Lp-PLA2水平的差异无统计学意义。结论 IS及其LAA亚型患者的血浆Lp-PLA2水平明显升高,Lp-PLA2基因I198T多态性与LAA的发生有密切关系,而与SAO和CE的发生可能无关。

Objective To investigate the relationship between ischemic stroke（IS） and its subtype with level of plasma lipoprotein-associated phospholipase A2 （Lp-PLA2） and Lp-PLA2 gene I198T polymorphism. Methods Two hundred and twenty-eight lS patients were divided into three subgroups according to trial of org10172 in acute stroke treatment （TOAST） classification, including large-artery atherosclerotic stoke （EAA, n = 123 ）, small-artery occlusion stroke （SAO,n = 71 ） and cardioemblism （CE, n = 34）. Enzyme linked immunosorbent assay （ELISA） was used to measure plasma Lp-PLA2 levels, while the I198T gene polymorphisms were analyzed by PCR and direct gene sequencing. Calculating IS relative odds ratio （OR） and comparing to 202 normal controls. Results The level of plasma Lp-PLA2 and frequency of mutant genotype and allele in Lp-PLA2 gene and IS relative OR value in IS group and LAA subgroup were all significantly higher than those in normal control group （ P 〈 0. 01 - 0. 001 ） , however, no statistical difference of those prior index were found between SAO or CE subgroup and normal control group. The level of plasma Lp-PLA2 in different genotype of each subgroup was no statistical difference. Conclusion The level of plasma Lp-PLA2 in IS and LAA subtype patients is significant increased, there is an intimate relationship between Lp-PLA2 gene I198T polymorphism and LAA,but may have no connection to SAO and CE.