血清Hcy、MTHFR基因多态性与血液病患者并发冠心病的相关性

Correlation between Serum Homocysteine Level, MTHFR Gene Polymorphism and Patients with Hematological Diseases Complicated with Coronary Heart Disease

目的:观察血液病并发冠状动脉粥样硬化性心脏病(简称冠心病)患者血清同型半胱氨酸(Hcy)表达水平及亚甲基四氢叶酸还原酶(MTHFR)基因多态性情况,分析血清Hcy水平及MTHFR基因多态性与血液病并发冠心病的关系。方法:回顾性收集2018年3月至2020年3月本院完成治疗的血液病并发冠心病患者80例病历资料,纳入观察组。另选取同期本院完成治疗的单纯血液病患者92例病历资料,纳入对照组。抽取两组患者静脉血,检测血清Hcy水平及MTHFR基因多态性,对比两组不同MTHFR基因分型血清Hcy水平,分析上述指标对血液病并发冠心病的影响。结果:观察组MTHFR基因TT、TC检出率均高于对照组,而MTHFR基因CC分布频率明显低于对照组(P<0.05)。观察组MTHFR基因TC、CC基因型患者血清Hcy水平均明显高于对照组(P<0.05)。二元Logistic回归分析结果显示,MTHFR基因TC/CC基因型血清Hcy过表达可能是诱发血液病患者并发冠心病的影响因素(OR=2.107/OR=1.634,P<0.05)。绘制ROC曲线结果显示,MTHFR基因TC/CC基因型血清Hcy水平预测血液病并发冠心病的AUC均>0.8;当MTHFR基因TC达到最佳阈值22.165μmol/L时,敏感度为0.950,特异度为0.837;当MTHFR基因CC达到最佳阈值19.630μmol/L时,敏感度为0.938,特异度为0.826,可获得最佳预测价值。结论:血清Hcy及MTHFR基因多态性改变可能参与血液病患者并发冠心病的病理过程,在未来临床可通过早期检测血液病患者的血清Hcy水平及MTHFR基因多态性,预测血液病患者合并冠心病的风险。

Objective:To observe the expression level of serum homocysteine(Hcy) and methylenetetrahydrofolate reductase(MTHFR) gene polymorphism in patients with hematological diseases complicated with coronary heart disease,and analyze the relationship between serum Hcy level,MTHFR gene polymorphism and coronary heart disease.Methods:The medical records of 80 patients with coronary heart disease who completed treatment of hematological diseases during the period from March 2018 to March 2020 were selected as observation group.In addition,the medical records of 92 patients with hematological diseases who completed treatment in our hospital during the same period were selected as control group.Venous blood samples of the two groups were collected to detect serum Hcy level and MTHFR gene polymorphism.The serum Hcy levels of the two groups with different MTHFR genotypes were compared,and the effects of the above indicators on hematological diseases complicated with coronary heart disease were analyzed.Results:The detection rates of MTHFR gene TT and TC in the observation group were higher than those in the control group,while the distribution frequency of MTHFR genotype CC was lower(P<0.05).The serum Hcy levels of the patients with MTHFR genotype TT and TC in the observation group was higher than the control group(P<0.05).Binary logistic regression analysis showed that MTHFR gene TC/CC genotype serum Hcy overexpression may be influencing factor which induced coronary heart disease in patients with hematological diseases(OR=2.107/OR=1.634,P<0.05).ROC curves showed that the AUC of serum Hcy level of MTHFR gene TC/CC genotype and hematological disease complicated with coronary heart disease were both> 0.8.When MTHFR gene TC reaching the optimal threshold of 22.165 μ mol/L,the sensitivity was 0.950 and the specificity was 0.837,While MTHFR gene CC reached the optimal threshold of 19.630 μ mol/L,the sensitivity was 0.938 and the specificity was 0.826,the best predictive value could be obtained.Conclusion:The changes of serum Hcy and MTHFR gene polymorphisms may be involved in the pathological process in patients with hematological diseases complicated with coronary heart disease.In the future,early detection of serum Hcy levels and MTHFR gene polymorphisms in patients with hematological diseases can be used to predict the risk of coronary heart disease.