COX-2基因多态性与服用阿司匹林治疗的大动脉粥样硬化型脑梗死患者临床预后的相关性研究

Association of COX-2 gene polymorphism and the clinical outcome of patients with atherosclerotic cerebral infarction treated with aspirin

目的研究长时间服用阿司匹林治疗的大动脉粥样硬化型脑梗死(LAA)患者的COX-2基因的多态性的临床预后。方法利用随机法选取2014~2016年确诊为LAA且长期服用阿司匹林的患者580例,并采用多重连接酶检测反应技术来对COX-2基因2个位点的基因型进行分析并记录其主要终点事件的例数,随访1~3年时间。结果rs20417的最小等位基因频率为5.0%,rs52577的最小等位基因频率为18.9%。随访1~3年期间,43例(7.41%)LAA患者发生主要终点事件。对比rs20417位点GG型和CC+CG型的主要终点事件的发生率差异无显著性(P>0.05);对比rs5257位点AG+GG型与AA型的主要终点事件的发生率差异无显著性(P>0.05)。男性患者预后较女性患者更好,rs20417和rs5275G等位基因的携带者与LAA的预后无相关(P>0.05)。结论长期服用阿司匹林的LAA患者的COX-2基因中的rs20417和rs5275G位点与其预后可能无关。

Objective To study the association of COX-2 gene polymorphism and the clinical outcome of patients with atherosclerotic cerebral infarction treated with aspirin. Methods A total of 580 patients diagnosed as this disease with long term using of aspirin were selected during2014 to 2016 by the method of random,and we used the multiple ligase detection reaction to analyze 2 polymorphisms of COX- 2 gene and the primary endpoint with the follow- up time ranged from 1 to 3 years. Results Rs20417 and rs5257 minimum allele frequencies were 5. 0%,18. 9%. Followed up for 1 to 3 years,there were 43 patients（ 7. 41%） with major end points in the patients with large atherosclerotic cerebral infarction. The incidence rate of the primary endpoint compared with rs20417 genotype GG and CCCG type showed no statistically significant difference（P〈0. 05）;the incidence of the primary endpoint compared to rs5257 sites AGGG type and AA type,suggested no statistical significant difference（P〈0. 05）.According to the COX- 2 matrix of various factors,we found that the prognosis of male patients were better than female patients,and rs20417 and rs5275 G alleles were not associated with the prognosis of patients with large atherosclerotic cerebral infarction（P〈0. 05）. Conclusion The rs20417 and rs5275 G loci of the COX- 2 gene in atherosclerotic cerebral infarction patients with long term aspirin may not be associated with the prognosis.