叶酸代谢基因及血浆同型半胱氨酸在老年脑卒中患者中的表达及相关性

Expression and correlation of folate metabolism gene and plasma homocysteine in elderly patients with stroke

目的探讨四氢叶酸还原酶(MTHFR)C677T位点、甲硫氨酸合成酶还原酶(MTRR)A66G位点及血浆同型半胱氨酸(Hcy)在老年脑卒中患者中的表达及相关性。方法选取2018年1月到2019年6月西宁市第二人民医院收治的80例老年脑卒中患者作为脑卒中组,另选择我院同期体检的73例健康人员作为对照组。采用PCR-RELP法检测患者MTHFR C677T位点和MTRR A66G位点基因多态性,采用全自动生化仪检测血浆Hcy水平,分析不同MTHER、MTRR基因型、血浆Hcy水平与脑卒中关系。结果脑卒中组TT型、GG型基因频率均高于对照组,CC型、AA型基因频率低于对照组(t=12.771、4.408、4.912、3.921,P<0.05)。脑卒中组各基因型Hcy水平均高于对照组,差异具有统计学意义(t=6.477、10.663、4.227、2.685、2.949、3.929,P<0.05),两组MTHFR C677T的TT型患者Hcy水平均高于CT型、CC型,差异具有统计学意义(P<0.05);两组MTRR A66G位点GG型患者Hcy水平均高于AG型、AA型,差异具有统计学意义(P<0.05)。Spearman相关性分析显示,MTHFR C677T位点、MTRR A66G位点各基因型频率均与Hcy水平呈正相关(r=0.779、0.684、0.716、0.806、0.758、0.818,P<0.05);Logistic回归分析显示,MTHFR C677T位点TT型、Hcy水平是影响脑卒中发生的危险因素[OR(95%CI)=3.167(1.421~5.385)、2.822(1.652~4.770),P<0.05]。结论老年脑卒中患者MTHFR C677T位点TT型、MTRR的A66G位点GG型基因频率、血浆Hcy水平高于健康人群,其中MTHFR C677T位点TT型基因频率、血浆Hcy水平是影响脑卒中发生的重要因素。

Objective To investigate the expression and correlation of methylenetetrahydrofolate reductase(MTHFR)C677T site,methionine synthase reductase(MTRR)A66G site and plasma homocysteine(Hcy)in elderly patients with stroke.Methods Eighty elderly patients with stroke in the Xining Second People's Hospital from January 2018 to June 2019 were enrolled as the stroke group.Another 73 healthy people in the hospital during the same period were selected as the control group.The locus gene polymorphism of MTHFR C677T and MTRR A66G were detected by PCR-RELP method.The plasma Hcy level was detected by automatic biochemical analyzer,and the correlation of MTHER and MTRR genotypes,plasma Hcy level and cerebral stroke was analyzed.Results TT type and GG type gene frequency in the stroke group were higher than those in the control group,while the gene frequency of CC type and AA type was lower than the control group(t=12.771,4.408,4.912,3.921;P<0.05).The Hcy level of each genotype in stroke group was higher than that in control group,and the difference was statistically significant(t=6.477,10.663,4.227,2.685,2.949,3.929;P<0.05).The Hcy level of TT type of MTHFR C677T in both groups was higher than that of CT type and CC type,and the differences were statistically significant(P<0.05).The Hcy level of GG type of MTRR A66G in both groups was higher than that of AG type and AA type,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that the gene frequencies at the MTHFR C677T site and the MTRR A66G site were positively correlated with Hcy level(r=0.779,0.684,0.716,0.806,0.758,0.818;P<0.05).Logistic regression analysis showed that TT type at MTHFR C677T locus and Hcy level were risk factors for the occurrence of stroke[OR(95%CI)=3.167(1.421-5.385),2.822(1.652-4.770);P<0.05].Conclusion The gene frequency of MTHFR C677T locus TT type and A66G locus GG type,and plasma Hcy level in elderly patients with stroke are higher than those in healthy people,of which MTHFR C677T locus TT type gene frequency and plasma Hcy level are important factors affecting stroke.