磷酸二酯酶4D基因与脑梗死患者颈动脉粥样硬化的关系

Association between phosphodiesterase 4D gene polymorphism and carotid atherosclerosis in patients with cerebral infarction

目的：探讨脑梗死患者磷酸二酯酶4D（PDE4D）基因SNP83的单核苷酸多态性与脑梗死患者颈动脉粥样硬化的关系。方法采用聚合酶链反应-限制性片段长度多态性方法分析350例脑梗死患者PDE4D基因SNP83的单核苷酸多态性。超声检查评估颈动脉斑块和颈总动脉（CCA）、颈内动脉（ICA）内中膜厚度。结果279例患者存在颈动脉斑块，易损斑块组CC＋CT基因型频率为47.1%，稳定斑块组为30.4%，两组比较差异有统计学意义[P=0.007，=2.034，95%CI（1.204~3.436）]；易损斑块组C等位基因频率为25.3%，稳定斑块组则为16.8%，两者比较差异有统计学意义[P=0.019，=1.682，95%CI（1.087~2.603）]。TT基因型和CC＋TT基因型CCA的IMT分别为（1.06±0.08）mm和（1.13±0.08）mm，两者差异具有统计学意义（=8.444，P＜0.05）。结论PDE4D基因SNP83位点单核苷酸多态性可能与浙江地区汉族脑梗死患者的颈动脉粥样硬化相关，C等位基因可能是颈动脉斑块易损和CCA IMT增厚的遗传易患性标志之一。

Objective To investigate the association between the single nucleotide polymorphism of SNP83 in phospho-diesterase 4D （PDE4D） gene and carotid atherosclerosis in patients with cerebral infarction. Methods Three hundred and fifty patients with cerebral infarction admitted in Department of Neurology, Taizhou Hospital were enrol ed in the study. The polymor-phism of SNP83 in PDE4D gene was detected with polymerase chain reaction- restriction fragment length polymorphism （PCR- RFLP）. The carotid plaque and intima- media thickness（IMT） of common carotid artery（CCA） and internal carotid artery （ICA） were evaluated by ultrasonography. Results Carotid plaques were detected in 279 acute infarction patients, including 85 cases with carotid vulnerable plaques and 194 cases with carotid stable plaques. The frequency of CC＋CT genotypes in vulner-able plaque group was significantly higher than that in stable plaque group （47.1% vs 30.4%, P=0.007, OR=2.034, 95%CI：1.204~3.436）, and the frequencies of C al ele were 25.3%and 16.8%in the two groups, respectively （P=0.019, OR=1.682, 95%CI：1.087~2.603）.The IMT of CCA in patients with TT and CC＋TT genotypes was 1.06±0.08mm and 1.13±0.08mm, respectively （t=8.444, P〈0.05）. Conclusion The single nucleotide polymorphism of SNP83 in PDE4D gene is associated with carotid atherosclerosis in patients with cerebral infarction and C al ele may be a predictor for the susceptibility of carotid vulnerable plaque and the increased IMT of CCA.