P2Y1和ITGt33基因多态性与中国汉族大动脉粥样硬化性卒中患者阿司匹林抵抗的相关性

Correlations of P2Y1 and 1TGB3 polymorphisms with aspirin resistance in patients with large artery atherosclerolic stroke

目的 探讨P2Y1和ITGB3基因单核苷酸多态性（single nucleotide polymorphism, SNP）与中国汉族大动脉粥样硬化性卒中（large-artery atherosclerosis, LAA）患者阿司匹林抵抗（aspirin resistance, AR）的相关性。 方法 纳入安徽卒中注册系统中的首发LAA患者，应用血栓弹力图检测血小板功能，采用TaqMan技术检测P2Y1和ITGB3基因型。 结果 共纳入206例LAA患者，31例（15.0%）发生AR，175例（85.0%）为阿司匹林敏感（aspirin sensitive, AS）。AR组P2Y1 rs701265 G等位基因频率显著高于AS组（43.5%对26.9%；χ2＝7.074，P＝0.008），AA基因型频率显著低于AS组（32.3%对53.7%；χ2＝4.850，P＝0.028）。AR组P2Y1 rs1065776和ITGB3 rs5918各等位基因和基因型频率与AS组差异均无统计学意义。多变量logistic回归分析显示，携带P2Y1 rs701265 G等位基因是LAA患者AR的独立危险因素（优势比2.186，95%可信区间1.190～4.016；P＝0.012）。 结论 P2Y1 rs701265多态性与中国汉族LAA患者AR有关，而P2Y1 rs1065776和ITGB3 rs5918多态性则不然。

Objective To investigate the correlations of P2Y1 and ITGB3 single nucleotide polymorphisms （SNP） with aspirin resistance （AR） in patients with large atherosclerotic stroke （LAA） in a Chinese Han population. Methods Patients with first-ever LAA from Anhui stroke registration system were enrolled. Thrombus elasticity diagram was used to detect the platelet function. TaqMan technology was used to detect the P2Y1 and ITGB3 genotypes. Results A total of 206 patients with LAA were enrolled. Thirty-one patients （15.0%） had AR and 175 （85.0%） were aspirin sensitive （AS）. The frequency of P2Y1 rs701265 G allele in the AR group was significantly higher than that in the AS group （43.5% vs. 26.9%; χ2=7.074, P=0.008）. The frequency of P2Y1 rs701265 AA genotype in the AR group was significantly lower than that in the AS group （32.3% vs. 53.7%; χ2=4.850, P=0.028）. There were no significant significances in the frequencies of P2Y1 rs1065776 and ITGB3 rs5918 alleles and genotypes between the AR group and the AS group. Multivariate logistic regression analysis showed that P2Y1 rs701265 G allele was an independent risk factor for AR in patients with LAA （odds ratio 2.186, 95% confidence interval 1.190-4.016; P=0.012）. Conclusion The P2Y1 rs701265 polymorphism is associated with AR in Chinese Han patients with LAA, while the P2Y1 rs1065776 and ITGB3 rs5918 polymorphisms are not.