一氧化氮合酶基因多态性与青年缺血性卒中的关系研究

Relationship between Endothelial Nitric Oxide Synthase Polymorphism in Young People with Ischemic Stroke

目的探讨一氧化氮合酶基因多态性在青年缺血性卒中发病机制中的作用。方法选取2011年4月—2012年7月首都医科大学附属北京天坛医院收治的青年缺血性卒中患者97例为研究组,另同时期遵循年龄、性别频数匹配的原则,选择来自其他科室的非缺血性卒中住院患者99例为对照组,收集患者性别、年龄、高血压、糖尿病、吸烟、饮酒情况,检测胆固醇、三酰甘油、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)水平,检测一氧化氮合酶内含子4(eNOS4)、亚甲基四氢叶酸还原酶(MTHFR)C677T、凝血因子ⅤG1691A基因的多态性。结果对照组与研究组高血压检出率、糖尿病检出率、吸烟率、饮酒率及胆固醇、三酰甘油、LDL水平比较,差异均有统计学意义(P<0.05)。对照组eNOS4 bb 81例、eNOS4 ab 18例,研究组eNOS4 bb 90例、eNOS4 ab 7例,两组eNOS4基因型分布比较,差异有统计学意义(P<0.05);对照组MTHFR 677TT 34例、MTHFR 677CT 45例、MTHFR 677CC 20例,研究组MTHFR 677TT 29例、MTHFR 677CT 45例、MTHFR 677CC 23例,两组MTHFR C677T基因型分布比较,差异无统计学意义(P>0.05);两组凝血因子Ⅴ基因型均为1691GG。多因素Logistic回归分析结果显示,高血压、糖尿病、吸烟、LDL水平、eNOS4基因型与青年缺血性卒中发生有回归关系(P<0.05)。结论 eNOS4基因的多态性可能是中国青年发生缺血性卒中的危险因子。

Objective To determine the possible contribution of the gene polymorphism of endothelial nitric oxide synthase on the occurrence of ischemic stroke in young people. Methods 97 patients with ischemic stroke admitted to the Beijing Tiantan Hospital Affiliated to Capital Medical University from April 2011 to July 2012 were selected as study group. Another 99 patients without ischemic stroke during the same period were selected as control group. The sex,age,hypertension,diabetes,smoking and drinking occurrence were collected,and serum cholesterol,triglycerides,HDL and LDL levels were detected. The gene polymorphism of eNOS4,MTHFR C677 T and coagulation factor V G1691 A were detected. Results The hypertension,diabetes,smoking rate,drinking rate,cholesterol,triglycerides and LDL between the control group and study group all showed statistically significant differences（ P〈0. 05）. In the control group,81 cases were eNOS4 bb and 18 cases were eNOS4 ab. While in the study group,90 cases were eNOS4 bb and 7 cases were eNOS4 ab,showing statistically significant differences（ P〈0.05）. In the control group,34 cases were MTHFR 677 TT,45 cases were MTHFR 677 CT,20 cases were MTHFR677 CC,while in the study group,29 cases were MTHFR 677 TT,45 cases were MTHFR 677 CT,23 cases were MTHFR677 CC,showing no statistically significant difference（ P〉0. 05）. The coagulation factor V of the two groups were both1691 GG. Multivariate Logistic regression analysis results showed that hypertension,diabetes,smoking,LDL,eNOS4 were the independent risk factors for the occurrence of ischemic stroke in young people（ P〈0. 05）. Conclusion The eNOS4 variant appears to be an important risk factor for ischemic stroke in young Chinese population.