急性脑血管病患者MTHFR基因多态性分布及血清同型半胱氨酸、脂蛋白相关磷脂酶A2水平的临床研究

The clinical study of MTHFR gene polymorphism in patients with acute cerebrovascular disease and the correlation of homocysteine and lipoprotein-associated phospholipaseA2

目的分析急性脑血管病患者亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性的临床分布特征及血清同型半胱氨酸(Hcy)、脂蛋白相关磷脂酶A2(Lp-PLA2)的相关性。方法收集2019年1-12月陆军军医大学第二附属医院神经内科收治的急性脑血管病患者328例,其中急性脑梗死153例,急性脑出血78例,短暂性脑缺血发作(TIA)97例。对3组患者MTHFR C677T基因多态性进行分析。同时检测3组患者血清Hcy、Lp-PLA2水平。结果急性脑血管病患者MTHFR C677T基因多态性在性别、年龄及临床诊断中的分布差异无统计学意义(P>0.05)。不同MTHFR C677T基因型急性脑血管病患者血清Hcy水平差异有统计学意义(Z=31.87,P<0.05),TT基因型患者血清Hcy水平明显高于CT及CC基因型患者。急性脑梗死、急性脑出血及TIA患者血清Lp-PLA2水平差异有统计学意义(Z=7.05,P<0.05)。结论急性脑血管病患者MTHFR C677T基因基因多态性无患者性别、年龄及临床诊断的差异。急性脑血管病患者MTHFR C677T基因多态性与血清Hcy水平相关,但MTHFR C677T基因多态性不影响血清Lp-PLA2水平。血清Lp-PLA2水平是急性脑梗死发生、发展的影响因素。

Objective To investigate the clinical distribution of methylene tetrahydrofolate reductase(MTHFR)C677T genotypes in patients with acute cerebrovascular disease and its relationship with blood homocysteine(Hcy)and lipoprotein-associated phospholipaseA2(Lp-PLA2).Methods A total of 328 patients with acute cerebrovascular disease were collected from January to December 2019 in the Second Affiliated Hospital to Army Medical University,including 153 patients with acute infarction,78 patients with acute cerebral hemorrhage,97 patients with TIA.The MTHFR C677T genotypes and the level of blood Hcy and Lp-PLA2 in three groups were detected.Results The distribution of MTHFR C677T genotypes in patients with acute cerebrovascular disease had no statistical differences in gender,age and clinical diagnosis(P>0.05).There was significant difference in the level of Hcy among patients with different genotypes of MTHFR C677T(Z=31.87,P<0.05).The Hcy level in patients with TT genotype was higher than those in the patients with CT type and CC type,and there was significant difference in the level of Lp-PLA2 among the 3 case groups(Z=7.05,P<0.05).Conclusion The distribution of MTHFR C677T gene polymorphism is not related to gender,age and clinical diagnosis.The level of Hcy is related to the MTHFR C677T genotypes.MTHFR C677T gene polymorphism does not affect the level of Lp-PLA2.The level of Lp-PLA2 is an influence factor for the occurrence and development of acute infarction.