原发性高血压患者亚甲基四氢叶酸还原酶基因多态性与脑出血的相关性研究

Correlation between MTHFR gene polymorphism and cerebral hemorrhage in essential hypertensive patients

目的 探讨新疆汉族人群中原发性高血压患者亚甲基四氢叶酸还原酶基因多态性与脑出血的相关性.方法 选择原发性高血压患者382例,根据头颅CT和（或）MRI证实是否有脑出血,分为脑出血组182例和单纯高血压组200例.采用高效液相色谱荧光检测法测定血浆同型半胱氨酸（Hcy）浓度,并运用PCR-RFLP检测基因表型.结果 脑出血组血浆Hcy水平明显高于单纯高血压组[（21.56±10.75）μmol/L]vs[（17.40±9.26）μmol/L,P〈0.05）;2组TT、CT基因型血浆Hcy水平明显高于CC型;TT基因型与CT基因型比较,差异无统计学意义（P〉0.05）.TT基因型男性比例明显高于CT及CC基因型,CC基因型体重指数明显低于CT及TT基因型（P〈0 05）,而TT与CT基因型比较,差异无统计学意义（P〉0.05）.多因素logistic回归分析显示,高Hcy是脑出血的独立危险因素（OR=1.07,95%CI：1.04~1.11,P〈0.05）.结论 新疆地区汉族人群原发性高血压患者亚甲基四氢叶酸还原酶基因多态性可能与脑出血的发生无关,而血浆Hcy可能与高血压协同促进脑出血的发生.

Objective To study the correlation between methylenetetrahydrofmate reductase （MTHFR） gene polymorphism and cerebral hemorrnage in xinjiang essential hypertensive Han nationality patients. Methods Three hundred and eighty-two essential hypertensive patients were divided into cerebral hemorrhage group （n= 182） and simple hypertension group （n=200） accord- ing to whether they had CT- and （or） MRI-confirmed cerebral hemorrhage. Their plasma Hcy levels were measured by HPLC fluorescence and their genotypes were detected by PCR-RFLP. Results The plasma Hey level was significantly higher in cerebral hemorrhage group than in simple hypertension group （21.56±10.75 /;mol/L vs 17.40±9. 26 μmol/L）,and in TT and CT genotypes than in CC genotype （P〈0.05）. However,no significant dfference was found in plasma Hcy level between TT and CT genotypes. Muhivariate logistic regression analysis showed that high plasma level was the independent risk factor for cerebral hemorrhage （OR= 1.07,95 %CI： 1.04- 1.11,P〈0.05）. Conclusion MTHFR gene polymorphism may not be correlated with cerebral hemorrnage in Xinjiang essential hypertensive patients. However,plasma Hcy level may be correlated with cerebral hemorrnage due to hypertension.