PEAR1基因多态性对长期服用阿司匹林脑梗死患者复发的影响

The effects of PEAR1 gene polymorphisms on recurrence of stroke in long-term taking aspirin patients with cerebral infarction

目的探讨血小板内皮聚集受体1(platelet endothelial aggregation receptor 1,PEAR1)基因多态性与脑梗死患者长期服用阿司匹林复发的相关性。方法对114例初发脑梗死后长期(≥1a)服用阿司匹林的患者,根据入组时是否脑梗死复发分为复发组(21例)与无复发组(93例),使用PEAR1基因芯片检测系统对2组患者的PEAR1基因型进行检测。结果 114例患者PEAR1检出GG、GA、AA三种基因型,其中野生型GG占50.9%,突变型GA占42.1%,AA占7.0%;复发组野生型GG频率明显低于无复发组(23.8%vs.57.0%,P<0.01),复发组纯合突变型AA的频率明显高于无复发组(28.6%vs.2.1%,P<0.01);2组GA频率无明显差异(47.6%vs.40.9%,P>0.05)。复发组年龄、吸烟、LDL-C、糖尿病比例明显偏高,差异有统计学意义(P<0.05)。Logistic回归分析显示,PEAR1基因变异与脑梗死复发显著相关(P=0.006)。结论 PEAR1基因变异与长期服用阿司匹林脑梗死卒中复发相关,PEAR1基因纯合突变增加脑梗死复发的风险。

Objective To investigate the relationship between PEARl gene polymorphisms and the recurrence of stroke in long-term taking aspirin patients with cerebral infarction. Methods 114 long-term （≥1 year） taking aspirin patients after the first attack of cerebral infarction were recruited and divided into two groups according to whether the stroke recurred or not. The geno- types of PEARl were detected with PEAR1 gene chip. Results In the 114 patients, three genotypes of PEAR1 were detected：wild type GG, Mutant heterozygous GA and Mutant homozygote AA, the frequencies were 50. 9%,42. 1% and 7. 0%, respectively. The GG genotype frequency of the stroke recurred group was significantly lower than that of the non-stroke recurred group （23.8% vs. 57.0% ,P〈0.01） ,and the AA genotype frequency of the stroke recurred group was significantly higher than that of the non- stroke recurred group （ （28.6% vs. 2.1%,P〈0. 01）. The GA genotype frequency was not significant difference between the 2 groups （47.6% vs. 40. 9% ,P〉0.05）. There were significant differences in age, smoking, LDL and diabetes （P〈0. 05）. It was identified that genetic variants of PEARl were associated with the recurrence of stroke by multiple logistic regression analysis （P=0.006）. Conclusion The genetic variants of PEARlwere associated with the recurrence of stroke in long-term taking aspirin patients after the first attack of cerebral infarction,mutant homozygote AA of PEARl increased the risk of stroke recurrence.