血小板膜P2Y12受体基因T744C多态性对外伤性脑梗死(PTCI)患者血小板聚合率及疗效的影响

Role of the T744C Polymorphism of the P2Y12 Gene on Platelet Response in Patients with Traumatic Cerebral Infarction and Efficacy

目的:外伤性脑梗死(posttraumatic cerebral infarction,PTCI)是颅脑损伤的常见并发症之一,P2Y12受体介导血小板聚集是血栓形成的重要通路,与血小板聚集形成密切相关。本研究探讨外伤性脑梗死发生发展与血小板膜P2Y12受体基因T744C基因多态性的关系。方法:用聚合酶链反应(PCR)和限制性酶切片段长度多态性(RFLP)技术对186例外伤性脑梗死患者P2Y12受体基因T744C多态性进行分析。分别在治疗前和治疗后对所有颅脑外伤患者的伤情GCS评分,并按基因型分组对照分析结果。结果:血小板膜T744C血小板膜T744C基因型基因频率分别为TT基因型59.14%、TC型32.26%、CC型8.60%,T等位基因75.27%、C等位基因24.73%;其中TT基因型对奥扎格雷反应较敏感,GCS评分预后好;而CC型对奥扎格雷反应性低,预后差。结论:T744C基因多态性中CC基因型可能导致外伤性脑梗死临床及预后存在明显的个体差异,与其对抗血小板药物抵抗有关。T744C的C等位基因可能是脑梗死的遗传危险因素,开展相关遗传学风险研究,对于进一步缓解脑梗症状、改善预后具有重要意义。

Objective： Traumatic cerebral infarction （PTCI） is a common complication of traumatic brain injury, which is closely related to plate let aggregation. The aim of this study was to evaluate the effect of polymorphisms affecting the P2Y 12 receptor （P2Y12 T744C） on modulating platelet function in acute PTCI patients on regular treatment. P2Y12 receptor-mediated platelet aggregation is an important pathway for thrombosis. This article explores the traumatic cerebral infarction film development and platelet P2Y12 receptor gene T744C gene polymorphism relationship. Methods GCS score evaluating the cure effect of PTCI patients. PCR-RFLP analysis of 186 cases of P2Y12 receptor gene T744C polymorphism. Results： The platelet membrane T744C genotype gene fi＇equencies 59.14% of the TT genotype, TC 32.26% CC 8.60%, the T alleles 75.27% and C alleles 24.73%. Among people with TT genotype, the GCS score and prognosis are better than CC group. What＇s more, the CC genotype reduces the ability of ozagrel to inhibit platelet aggregation. Conclusion： T744C gene polymorphism CC genotype is a high risk of the disease. T744C C allele may be a genetic risk factor of cerebral infarction. More studies are needed to determine the possible interaction between the genetics factors, platelet response to ozagrel and long term prognosis.