亚甲基四氢叶酸还原酶基因多态性与老年非痴呆型血管性认知功能障碍患者预后的相关性

Correlation between MTHFR Gene Polymorphism and Prognosis in Older Patients with Vascular Cognitive Dysfunction No dementia

目的探讨亚甲基四氢叶酸还原酶(MTHFR)基因多态性与老年非痴呆型血管性认知功能障碍(VCIND)患者预后的相关性。方法选取天门市第一人民医院2016年5月~2018年12月收治的老年VCIND患者76例,所有患者均于入院时进行MTHFR基因多态性检测并采用石杉碱甲联合丁苯酞进行治疗,连续用药20 d。根据预后结果将患者分为预后良好组(42例)与预后不良组(34例),比较两组A1298C位点上AA、AC、CC基因型分布与A、C等位基因频率及C677T位点上CC、CT、TT基因型分布与C、T等位基因频率。结果预后不良组中CC基因型的占比显著高于预后良好组(P<0.05)。预后不良组中A1298C位点CC基因型的占比显著高于预后良好组(P<0.05)。预后不良组中A1298C位点C等位基因频率显著高于预后良好组(P<0.05)。两组C677T位点CC、CT、TT基因型分布及C677T位点C、T等位基因频率的差异无统计学意义(P>0.05)。多因素回归分析显示,以A1298C AC等位基因、C677T TT等位基因为参照,A1298C AA及CC相对危险度分别为1.715、1.258,C677T CC及CT相对危险度为1.799、1.844,差异均有统计学意义(P<0.05)。结论MTHFR基因A1298C位点基因多态性与老年VCIND的预后明显相关,携带C等位基因较A等位基因的预后不良风险相对更高。C677T位点基因多态性对老年VCIND的预后无明显影响。

Objective To investigate the correlation between methylenetetrahydrofolate reductase(MTHFR)gene polymorphism and prognosis in older patients with vascular cognitive impairment no dementia(VCIND).Methods 76 older VCIND patients in the First People’s Hospital of Tianmen were enrolled from May 2016 to December 2018.All patients were tested for MTHFR gene polymorphism at the time of admission and were treated with huperzine A plus butylphthalide for 20 d.According to the prognosis,the patients were divided into a group with good prognosis(42 cases)and a group with poor prognosis(34 cases).The distribution of AA,AC,CC genotypes and the frequencies of A,C allele at A1298 C locus,and the distribution of CC,CT,TT genotypes and the frequencies of C,T allele at C677 T locus were compared between the two groups.Results The proportion of CC genotypes in group with poor prognosis was significantly higher than that in group with good prognosis(P<0.05).The proportion of CC genotype at A1298 C locus in group with poor prognosis was significantly higher than that in group with good prognosis(P<0.05).The frequency of C allele at A1298 C locus in group with poor prognosis was significantly higher than that in group with good prognosis(P<0.05).There were no significant differences in the distribution of CC,CT and TT genotype at C677 T locus and the frequencies of C and T allele at C677 T locus between the two groups(P>0.05).Multivariate regression analysis showed that taking A1298 C AC allele and C677 T TT allele as reference,the relative risks for A1298 C AA and CC were 1.715 and 1.258 respectively,and the relative risks for C677 T CC and CT were1.799 and 1.844 respectively,the differences were significant(P<0.05).Conclusion A1298 C locus polymorphism of MTHFR gene is significantly associated with the prognosis of older VCIND patients.The risk of poor prognosis with C allele is higher than that with A allele.C677 T locus gene polymorphism has no significant effect on the prognosis of older VCIND patients.