MTHFR C677T基因多态性对干预Hhcy后脑梗死复发的影响

Effect of MTHFR C677T gene polymorphism on recurrence of cerebral infarction after Hhcy intervention

目的观察5,10-亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性对干预高同型半胱氨酸血症后脑梗死复发的修饰作用。方法 363例合并Hhcy脑梗死患者,180例给予干预Hhcy及标准二级预防治疗,183例给予标准治疗。随访1a观察不同MTHFR基因型脑梗死干预Hhcy后卒中复发的情况。结果 CC型患者标准治疗+干预Hhcy组1a卒中复发率19.64%,与标准治疗组(21.8%)比较差异无统计学意义。CT基因型患者中标准治疗+干预Hhcy组卒中复发率18.42%,与标准治疗组(19.5%)比较差异无统计学意义。TT基因型中标准治疗+干预Hhcy组1a卒中复发率10.20%,标准治疗组26%,两种卒中复发率比较差异有统计学意义(P<0.05)。在TT基因型患者中,对影响卒中复发的单因素给予Logistics多因素分析,显示干预Hhcy治疗降低TT基因型卒中复发风险,OR值0.678。结论 MTHFR 677位TT基因型患者干预Hhcy后能够降低缺血性卒中复发风险。

Objective To observe the modification effect of 5,10-methylenetetrahydrofolate reductase（MTHFR）C677 T gene polymorphism on the recurrence of cerebral infarction after hyperhomocysteinemia.Methods Among 363 patients with Hhcy cerebral infarction,180 patients with Hhcy and standard secondary prevention and 183 were given standard treatment.The followup of 1 year was observed to observe the recurrence of stroke after Hhcy intervention in different MTHFR genotypes.Results The one-year stroke recurrence rate of MTHFR677 CC patients in the Hhcy intervention group was 19.64%.There was no statistically significant difference between the two recurrence rates in the standard treatment group（21.8%）.The recurrence rate stroke of MTHFR677 CT patientsi in the Hhcy intervention group was 18.42%.There was no statistically significant difference between the two recurrence rates in the standard treatment group（19.5%）.The recurrence rate of 1-year strokef of MTHFR677 CC patients in the Hhcy intervention group was 10.20%.In the standard treatment group26%,there was a significant statistical difference between the two stroke recurrence rates（P〈0.05）.In TT genotype patients,the factor influencing the recurrence of stroke was analyzed by Logistics regression,indicating that Hhcy intervention was a protective factor to reduce the recurrence of TT genotype stroke,OR value of 0.678.Conclusion MTHFR 677 TT genotype patients can reduce the risk of ischemic stroke recurrence after Hhcy intervention.