Relationship between the -455G/A and -148C/T polymorphisms in the beta-fibrinogen gene and cerebral infarction in the Xinjiang Uygur and Han Chinese populations

We sought to investigate the correlation between the -455G/A and -148C/T polymorphisms of the β-fibrinogen gene and plasma fibrinogen levels in patients with cerebral infarction and in healthy subjects among the Xinjiang Uygur and Han Chinese populations, by using polymerase chain reaction-restriction enzyme digestion analysis. Results showed that there were no statistically significant differences in the distributions of the -455G/A genotype and allele frequency between the Uygurs and the Han. Plasma fibrinogen levels in cerebral infarction patients among the Uygurs and the Han were higher than those among healthy subjects. In particular, the frequencies of the -455G/A AA and -148C/T TT genotypes were significantly higher than in healthy subjects. Individuals carrying the A or T allele had a higher incidence of cerebral infarction compared with those carrying the G or C allele. Our experimental findings indicate that the -148C/T and -455G/A polymorphisms are associated with cerebral infarction in Xinjiang Uygur and Han Chinese subjects. The susceptibility- conferring alleles are -148T and -455A, and the susceptibility-conferring genotype is -455G/A ＋ AA.

A Meta-analysis of β-fibrinogen Gene-455G/A Polymorphism and Plasma Fibrinogen Level in Chinese Cerebral Infarction Patients

Objective To evaluate the correlation between the β-fibrinogen gene-455G/A polymorphism and cerebral infarction in Chinese population by means of meta-analysis. Methods Genetic association studies on evaluating the β-fibrinogen gene -455G/A polymorphism and cerebral infarction involving Chinese population published before December 2005 were collected from database of PubMed, EMBASE, and CNKI. All the data in literature were abstracted based on the defined selection criteria by two independent investigators. Publication bias was tested by funnel plot and the odd ratios of all studies were combined dependent on the result of heterogeneity test among the individual studies. The software Review Manager （Version 4.2） was used for meta-analysis. Results Eleven studies including 1405 patients and 1600 controls met the selection criteria. There was no publication bias in 11 reviewed studies. Heterogeneity test of reviewed studies showed statistically significant differences （χ^2=24.58, P=0.006） among the ORs of individual studies. The combined OR of 11 studies of susceptibility to cerebral infarction in –455A allele carriers compared with the -455G/G wild homozygotes was 1.33 （95%CI 1.04-1.71, P=0.02）. In the patients with cerebral infarction in 6 studies, the summarized average plasma fibrinogen level of allele A carrier was 0.29 g/L （95%CI 0.14-0.44, P=0.0002） higher than that of -455G/G homozygous ones. Conclusions β-fibrinogen gene -455G/A polymorphism might contribute to susceptibility of cerebral infarction in Chinese population; allele A increases the individual susceptibility to the disease.

Relationship between R219K polymorphism of adenosine triphosphate-binding cassette transporter 1 gene and cerebral infarction: A case-controlled analysis

BACKGROUND： Studies have shown that adenosine triphosphate-binding cassette transporter 1 （ABCA1） gene influences atherosclerosis. Studies have also demonstrated that cerebral infarction does not occur often in pre-menopausal women. It has been, therefore, assumed that sex plays a role in R219K polymorphism of ABCA1 gene and cerebral infarction. OBJECTIVE： To explore the relationship between lipid metabolism-correlated R219K polymorphism of ABCA1 gene, risk factors of cerebral infarction and lipid level, and to determine whether there were significant differences in gender between R219K polymorphism of ABCA1 gene and cerebral infarction. DESIGN, TIME AND SETTING： A multicentral and non-randomized, controlled study based on gene polymorphism was performed at the Chinese National Human Genome Center, and lipid concentrations were measured at Beijing Xuanwu Hospital. Patients with cerebral infarction and healthy subjects were enrolled from eight hospitals of six provinces of China between October 2002 and December 2004. PARTICIPANTS： There were 177 patients in the cerebral infarction group, including 119 males and 58 females, with a mean age of （60 -＋ 13） years, and 234 healthy subjects in the normal control group, including 79 males and 155 females, with a mean age of （58 ± 12） years. METHODS： R219K polymorphism of the ABCA1 gene was detected using polymerase chain reaction-restriction fragment length polymorphism, and blood lipid concentrations were simultaneously measured. MAIN OUTCOME MEASURES： Genotype and allele frequency of R219K polymorphic site, and blood lipid concentrations. RESULTS： RR genotype and R allele frequency of males in the cerebral infarction were significantly greater than males in the normal control group [RR genotype： x2 = 5.305, OR （95% CO, 2.326 （1.120 4.828）, P〈 0.05; R allele： x2= 4.219, OR （95% CO, 1.528 （1.019 2.292）, P〈 0.05]. In addition, RR genotype and R allele frequency of males were significantly greater than females in the cerebral infarction group [RR genotype： x2= 5.172, OR （95% C/）, 2.604 （1.120-6.057）, P〈 0.05; R allele： x2= 4.818, OR （95% CO, 1.652 （1.053 2.589）, P〈 0.05]. There were no significant differences between genotype and lipid concentrations between the two groups （P〉 0.05）. CONCLUSION： The RR genotype of ABCA1 R219K might be associated with onset of cerebral infarction in males, but blood lipid concentrations do not relate to R219K polymorphism.

Plasma fibrinogen beta-148C/T gene polymorphism in cerebral infarction patients

BACKGROUND： Plasma fibrinogen （Fg） β-148C/T gene polymorphism is a risk factor for ischemic angiopathy. OBJECTIVE： To explore the frequency distribution of Fg β- 148C/T gene polymorphism and its relationship with plasma Fg levels in patients with cerebral infarction. DESIGN, TIME AND SETTING： Case control experiment of gene polymorphism was performed at the Central Laboratory of Qingdao University Medical College from January 2003 to June 2004. PARTICIPANTS： A total of 88 patients with cerebral infarction were recruited from the Affiliated Hospital of Qingdao University Medical College, including 52 males and 36 females, averaging （61±14） years of age In addition, 80 healthy cases served as the control group, comprising 48 males and 32 females, with an average age of （58 ± 12） years. METHODS： Blood DNA was extracted, and electrophoresis results were observed using an ultraviolet single photon image system. The frequency distribution of Fg β -148C/T was analyzed by polymerase chain reaction-restriction fragment length polymorphism method. Plasma Fg levels were measured by cerebral infarction time. MAIN OUTCOME MEASURES： Plasma Fg β -148C/T gene polymorphism and plasma Fg levels in patients with cerebral infarction. RESULTS： The frequency of the T allele, and plasma Fg levels in CC, CT, and CC＋CT genotype subgroup, were significantly greater in the cerebral infraction group, compared with the control group （P 〈 0.05）. However, there was no significant difference between the TT genotype subgroup and the control group （P 〉 0.05）. The plasma Fg levels in the CT, TT, and CT＋TT genotype groups were significantly greater than the CC genotype group （P 〈 0.05）. However, in the control group, plasma Fg levels in the TT genotype subgroup were significantly greater than the remaining genotype subgroups （P 〈 0.05）. CONCLUSION： Plasma Fg β -148C/T gene polymorphism is an important hereditary factor for differences in plasma Fg levels. The T allele plays a crucial role in influencing plasma Fg levels in cerebral infarction. Fg β - 148C/T may be a susceptibility factor for cerebral infarction.

Correlation between peripheral blood Cx40 gene polymorphism and atherosclerotic plaque property development in patients with cerebral infarction

Objective:To study the correlation between peripheral blood connexin 40 (Cx40) gene polymorphism and atherosclerotic plaque property development in patients with cerebral infarction.Methods: Patients who were treated in the Second Affiliated Hospital of Xi'an Medical University due to acute cerebral infarction between March 2015 and March 2018 were selected as cerebral infarction group, and healthy subjects who received physical examination during the same period were selected as control group. Peripheral blood was collected to detect the polymorphism of Cx40 gene rs35594137 locus, and serum was collected to determine the contents of cytokines, proteases and related molecules.Results: The constituent ratio of Cx40 gene AA+AG genotype in peripheral blood of cerebral infarction group was higher than that of control group whereas the constituent ratio of GG genotype was lower than that of control group;serum IL-17, HMGB1, VCAM1, MCP-1, P-selectin, YKL-40, MMP9, TIMP1 and Caspase-3 contents as well as MMP9/TIMP1 ratio of cerebral infarction group were significantly higher than those of control group whereas ADAMTS13 and Vaspin contents were significantly lower than those of control group;serum IL-17, HMGB1, VCAM1, MCP-1, P-selectin, YKL-40, MMP9, TIMP1 and Caspase-3 contents as well as MMP9/TIMP1 ratio of cerebral infarction group of patients with CX40 gene AA+AG genotype were significantly higher than those of patients with GG genotype whereas ADAMTS13 and Vaspin contents were significantly lower than those of patients with GG genotype.Conclusion: The mutation from Cx40 gene rs35594137 allele G to A in peripheral blood of patients with cerebral infarction can promote the development of atherosclerotic plaque properties.

Effect of paraoxonase1 gene polymorphism on carotid plaque and cerebral infarction in Hainan population

Objective:To investigate the effect of paraoxonase 1 gene polymorphism on carotid plaque stability with cerebral infarction in Hainan population.Methods:277 patients of caroticl plaque With cerebral infarction who underwent physical examination in a hospital in Hainan from 2015 to another awarding 2018 were selected as the experimental group and the 363 people who no cerebral infarction as the Analytical methods:control group.The clinical data analyzed.DNA was collected from peripheral blood of two groups of patients and genotyped by flight mass analytical methods.''AG and GG could be detected by rs3917538.The distribution frequencies of The three genotypes in The control group accorded with Hardy-Weinberg equilibrium.Results:The distribution frequencies of AA,AG and GG in the control group were 97(26.7%),175(48.2%)and 91(25.1%)respectively.In the experimental group,the distribution frequencies were 76(27.4%),136(49.1%)and 65(23.5%).There were no statistical differences among the three detection methods of co-dominant model,Dominant model and recessive model.There was no difference in the frequency of allele A and G between groups.Conclusion:Polymorphism of paraoxonase 1 gene rs3917538 has No significant effect on carotid plaque formation and cerebral infarction in Hainan population.The Supplementary sample size to add more SNP research sites for further study,It is expected to further Revral the relationship between PON1and carotial piaque complicatecl with cerebral infarction in Hainan.

Analysis of relationship between cerebral infarction and behavioral factors and gene polymorphism of Bβ-FBG-455G/A by Logistic analysis

Objective To investigate the relationship between FBG levle,and pol;ymorphism of Bβ FBG 455G/A and other associated factors in patients with cerebral infarction.Method The relationship between FBG level,polymorphism of Bβ FBG 455G/A and related factors such as risk factors,hypertension,diabetes,smoking were analyzed by using logistic regression.Result The principal risk factors related to cerebral infarction are hypertension,smoking,diabetes,FBG,and polymorphism of Bβ FBG 455G/A related to FBG.Conclusion FBG is another risk factor of stroke besides hypertension,smoke,and diabetes.

Association of plasminogen activator inhibitor-1 4G/5G promoter polymorphism with recurrent cerebral infarction in China’s North Jiangsu Province

BACKGROUND： Many international studies have shown that plasminogen activator inhibitor-1 （PAl-l） 4G/5G promoter polymorphism does not increase the risk for cerebral infarction. OBJECTIVE： Using PCR methodology and agarose electrophoresis to detect PAI-1 4G/5G promoter polymorphism in patients with recurrent cerebral infarction in the North Jiangsu Province of China, and to compare results with healthy subjects and patients with first-occurrence cerebral infarction in the same region. DESIGN, TIME AND SETTING： Non-randomized, concurrent, control trial. A total of 122 cerebral infarction patients were admitted to Xuzhou Medical College Hospital＇s Department of Neurology and Xuzhou Central Hospital＇s Department of Neurology between July 2003 and August 2006. PARTICIPANTS： The patients consisted of 63 males and 59 females, aged （62 ± 10） years. They were divided into first-occurrence （n = 58） and recurrence （n = 64） groups. In addition, 50 healthy subjects that underwent physical examination in the outpatient department, including 26 males and 24 females, aged （60 ±12） years, were selected as controls. METHODS AND MAIN OUTCOME MEASURES： PAl-1 4G/5G promoter polymorphism was detected and analyzed using PCR methodology and agarose electrophoresis. RESULTS： Significant differences were determined in terms of genotypic frequency and allele frequency of PAI-1 4G/5G promoter polymorphism, in patients with first-occurrence or recurrent cerebral infarction, when compared with healthy subjects （P 〈 0.05）. There was, however, no significant difference between the first-occurrence and recurrence groups （P 〉 0.05）. CONCLUSION： PAl- 1 4G/5G promoter polymorphism is genetic risk factor for cerebral infarction in China. However, it may be associated with recurrence of cerebral infarction in patients from the North Jiangsu Province of China.

Correlation between angiotensinogen gene and primary hypertension with cerebral infarction in the Li nationality of China

Objective To investigate the relationship of four single nucleotide polymorphism （SNP） haplotypes in the angiotensinogen （AGT） gene to the primary hypertension with or without cerebral infarction in the Li nationality of Hainan, China. Methods Total 300 subjects were allocated into three different groups： Groupl, 100 patients who have primary hypertension; Group 2, 100 patients who have primary hypertension with cerebral infarction; and control group, 100 healthy individuals. The genotypes of all subjects were determined by PCR-sequencing to analyze the four poly- morphisms at position - 152 （G-A）, -20 （A-C）, - 18 （C-T）, and -6 （A-G） in the promoter region of AGT. Results The frequen- cies ofCT genotype of AGT-18 and T allele in Group 1 （P = 0.003, P = 0.004） and Group 2 （P = 0.002, P = 0.002） were both significantly higher than in healthy controls. The frequency of G allele of AGT-6 was significantly higher in Group 2 than in the control group （P = 0.016）, while there is no significant difference between Group 1 and the control. Haplotype analysis revealed that H6 haplotype frequency which included -20C and -6G was significantly increased in Group 2 （P = 0.003） compared with the control group, while H5 haplotype frequency which included -20C and -18T was signifi- cantly increased in Group 1 （P = 0.006） versus the control. Conclusion The -20 （A-C） and - 18 （C-T） of the AGT may play an important role in pathogenesis of primary hypertension; and -20 （A-C）, -18 （C-T）, and -6 （A-G） may be the genetic risk factors for the onset of primary hypertension with cerebral infarction in the Li nationality of Halnan, China.

Apolipoprotein E gene polymorphism in cerebrovascular diseases of the Chinese Naxi populations from Yunnan province

Currently it is not well known whether apolipoprotein E （ApoE） is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population. The present study detected and sequenced ApoE polymorphisms of 90 patients with cerebrovascular diseases （58 cases of cerebral infarction and 32 cases of intracerebral hemorrhage）, and 50 normal people of Naxi nationality from Yunnan province, China. The populations were used to analyze the relationship of ApoE polymorphisms with cerebral infarction and intracerebral hemorrhage. Results showed an association between ApoE gene polymorphism and the onset of cerebral infarction, and a possibility that the ε4 allele is a susceptibility locus for the risk of cerebral infarction. However, there was no evidence of a relationship between the ApoE gene polymorphism and cerebral hemorrhage.

Tag single nucleotide polymorphism rs1532624 located in cholesteryl ester transfer protein gene is associated with atherosclerosis cerebral ischemia

Objective: To investigate the relationship between polymorphisms of rs1532624 and rs289741 loci in cholesteryl ester transfer protein(CETP) genes and atherosclerotic cerebral infarction(ACI). Methods: The CETP gene rs1532624 and rs289741 in 95 patients with ACI and 177 healthy subjects were genotyped by Mass ARRAY mass spectrometry. Each locus genotype and allele frequency distributions were compared. Results: The difference of allele frequency distribution between the rs1532624(χ~2=1.723, P=0.189) and rs289741(χ~2=2.466, P=0.116) were not statistically significant. The frequency distribution of rs1532624 genotype between the cerebral infarction group and healthy control group was statistically significant(χ~2=7.096, P=0.029), while rs289741 genotype frequency distribution between the two groups was not statistically significant(χ~2=2.906, P=0.234). Conclusion: ACI have a positive correlation with rs1532624 polymorphism, and AA genotype may be susceptible factors of ACI.

APOLIPOPROTEIN(a) AND CORTICAL CEREBRAL INFARCTION

Objective. The present study aimed to elucidating the correlation of apolipoprotein(a)[apo(a)] with cerebral infarction at the levels of molecule and protein. Methods. The serum Lp(a) level, by means of ELISA, the polymorphism of apo(a) protein, by SDS PAGE/Western blotting combined with silver staining assays, and the sequence polymorphisms in 5’ control region, the first exon and intron of apo(a)gene, by PCR SSCP/AFLP assays, were detected in 85 healthy controls and 42 cases of cortical cerebral infarction. Results. The serum Lp(a) level was markedly higher in the patients(152.59±3.41 mg/L)than that in the controls(56.21±3.67 mg/L)(t=4.15, P<0.001), even between the subjects with the same apo(a) phenotype. The frequency of low molecular weight phenotype was significantly higher in the patients than that in the controls(0.5238 vs. 0.2941). There were 2 sites of sequence variance in the 5’ control region of apo(a) gene in our studied population, which were of significant difference between patients and controls, and were related to the variation of serum Lp(a) level. Conclusion. Our study found that the low molecular weight phenotype of apo(a) was closely associated with cerebral infarction, suggested that the variation of serum Lp(a) level be determined by not only the size of apo(a) gene but also its sequence, which indicated that both the size and sequence of apo(a) are associated with the susceptibility to cerebral infarction.

A meta-analysis of relationship between β-fibrinogen gene-148C/T polymorphism and susceptibility to cerebral infarction in Han Chinese

Objective The results of studies on association between -148C/T polymorphism in promoter region of β3-fibrinogen gene and susceptibility to cerebral infarction in Chinese population are controversial. In this study, we summarize the results of published works in this field by a meta-analysis. Data sources Genetic association studies evaluating the β-fibdnogen gene -148C/T polymorphisms and cerebral infarction involving Chinese population published before December 2005 were collected from PubMed, EMBASE and CNKI. Study selection Case control studies involving unrelated, Han subjects aged from 18 to 80 years, and the internationally recognized diagnostic standard of cerebral infarction and genotype frequencies in control group consistent with Hardy-Weinberg equilibrium were used. Publication bias was tested by funnel plot and the odds ratios of all studies were combined dependent on the result of heterogeneity test among the individual studies. The software Review Manager （Version 4.2） was used for meta-analysis. Results Eleven studies including 1223 patients and 1433 controls met the selection criteria. There was no heterogeneity among the odds ratios （ORs） of individual studies （Х^2=17.82, P=0.06）. The combined OFt of susceptibility to cerebral infarction in -148T allele carriers compared to the wild homozygote was 1.32 （95%CI 1.12 to 1.55, P=-0.0008）. In the patients with cerebral infarction, the average plasma fibrinogen level of allele T carrier was 0.42 g/L （95% CI 0.29 to 0.54, P〈0.001）, higher than that of -148C/C homozygous ones. Conclusions β3-fibrinogen gene -148C/T polymorphism might contribute to susceptibility to cerebral infarction in Han Chinese. To reach a definitive conclusion, further gene to gene and gene to environment interactions studies on β3-fibrinogen polymorphisms and cerebral infarction with large sample size are required.

Relationship between a novel polymorphism of lipoprotein lipase gene and coronary heart disease

OBJECTIVE: To investigate polymorphisms in the gene for lipoprotein lipase (LPL) in Chinese populations with coronary heart disease (CHD) and to inquire into the relationship between these polymorphisms in LPL gene and CHD. METHODS: Genomic DNA was extracted from patients with CHD and normal control subjects using a salting out method. The entire coding region and flanking sequences of all coding exons of the LPL gene were amplified by PCR technique and PCR products were detected by denaturing high-performance liquid chromatography (DHPLC) and sequenced with a dideoxy terminal termination method. RESULTS: A novel polymorphic site, G830A, that is within the fifth exon of the LPL gene was found. The 192 codon CGA was changed into CAA and resulted in the substitution of glutamine for arginine. Between the control and CHD groups, chi-square test showed no significant difference in the frequencies of the A/A genotype and A allele (P > 0.05). However, the frequencies of A/A genotype and A allele (0.653 and 0.786) in CHD patients with high plasma triglyceride/lowed plasma high density lipoprotein cholesterol were higher than those (0.415 and 0.642) in CHD patients without hyperlipidemia (P Gln substitution polymorphism and CHD, but there is a significant positive correlation between the A/A genotype of the LPL gene and CHD associated with high triglyceride/lowed high density lipoprotein cholesterol. This study may provide new data for exploring the molecular mechanism of CHD.

Apolipoprotein A-V gene therapy for disease prevention/treatment:a critical analysis

Apolipoprotein（apo） A-V is a novel member of the class of exchangeable apo＇s involved in triacylglycerol（TG）homeostasis.Whereas a portion of hepatic-derived apoA-V is secreted into plasma and functions to facilitate lipoprotein Iipase-mediated TG hydrolysis,another portion is recovered intracellularly,in association with cytosolic lipid droplets.Loss of apo A-V function is positively correlated with elevated plasma TG and increased risk of cardiovascular disease.Single nucleotide polymorphisms（SNP） in the APOA5 locus can affect transcription efficiency or introduce deleterious amino acid substitutions.Likewise,rare mutations in APOA5 that compromise functionality are associated with increased plasma TG and premature myocardial infarction.Genetically engineered mouse models and human population studies suggest that,in certain instances,supplementation with wild type（WT） apoA-V may have therapeutic benefit.It is hypothesized that individuals that manifest elevated plasma TG owing to deleterious APOA5 SNPs or rare mutations would respond to WT apoA-V supplementation with improved plasma TG clearance.On the other hand,subjects with hypertriglyceridemia of independent origin（unrelated to apoA-V function） may not respond to apoA-V augmentation in this manner.Improvement in the ability to identify individuals predicted to benefit,advances in gene transfer technology and the strong connection between HTG and heart disease,point to apoA-V supplementation as a viable disease prevention / therapeutic strategy.Candidates would include individuals that manifest chronic TG elevation,have low plasma apoA-V due to an APOA5 mutation/polymorphism and not have deleterious mutations/polymorphisms in other genes known to influence plasma TG levels.

APOA5-1131T>C polymorphism is associated with atherosclerotic cerebral infarction in Han Chinese

Background Apolipoprotein （apo） A-V is a novel member of the apolipoprotein cluster involved in triacylglycerol （TG） homeostasis. It has reported that APOA5 gene polymorphisms is correlated with arteriosclerotic diseases. However, This association is unknown on Chinese patients with atherosclerotic cerebral infarction. The present study aimed to elucidate the relationship of APOA5 -1131T 〉 C and arteriosclerotic cerebral infarction （ACI） as well as the levels of serum lipids. Methods Polymerase chain reaction-restriction fragments length polymorphisms （PCR-RFLP） analysis, enzymatic and immunoturbidimetry methods were used to measure- 1131T 〉 C genotype, allele frequency as well as plasma lipid level of 90 ACI patients and 221 healthy subjects of Han Chinese. Results In ACI group, the level of TG in allele C carriers was higher than that of non-C carriers （P 〈 0.05）. The frequency of allele C in ACI group was higher than in healthy group （~2 = 5.568, P = 0.018）. Except sex, age and BMI, the levels of total cholesterol （TC）, triglycerides （TG）, high density lipoprotein choles- terol （HDL-C）, low-density lipoprotein cholesterol （LDL-C）, APOA1 and APOB in ACI group distinctively were higher than those in healthy group. Conclusion The APOA5-1131 allele C is associated with the high level of TG in ACI patients, which is probably linked with ACI danger of Chinese Han.

MTHFR基因多态性对脑梗死患者阿替普酶静脉溶栓后出血性转化的影响

目的分析亚甲基四氢叶酸还原酶(MTHFR)基因多态性对脑梗死患者阿替普酶静脉溶栓后出血性转化(HT)的影响。方法回顾性分析2020年7月—2023年7月在安徽医科大学附属阜阳人民医院接受治疗的120例脑梗死患者的临床资料。依据治疗后24~72 h HT发生情况分为HT组(15例)、无HT组(105例)。比较两组基线资料、MTHFR基因多态性、纤维蛋白原(Fib)、同型半胱氨酸(Hcy)。采用多因素一般Logistic回归模型分析脑梗死患者阿替普酶静脉溶栓后HT发生的危险因素。绘制受试者工作特征(ROC)曲线,分析入院时美国国立卫生院卒中量表(NIHSS)评分、Hcy预测脑梗死患者阿替普酶静脉溶栓后HT发生的价值。结果HT组心房颤动发生率、MTHFR基因型677CT占比、入院时NIHSS评分、Hcy水平均高于无HT组(P<0.05)。多因素一般Logistic回归分析结果显示:心房颤动史[OR=1.478(95%CI:1.126,1.940)]、入院时NIHSS评分升高[OR=1.656(95%CI:1.125,2.438)]、MTHFR基因型为677CT[OR=1.871/2.362(95%CI:1.052,3.328/1.081,4.652)]、Hcy水平升高[OR=2.149(95%CI:1.108,4.168)]均为脑梗死患者阿替普酶静脉溶栓后HT发生的危险因素(P<0.05)。ROC曲线分析结果显示,入院时NIHSS评分、Hcy均可预测脑梗死患者阿替普酶静脉溶栓后HT发生,其敏感性分别为80.0%(95%CI:0.765,0.883)、73.3%(95%CI:0.717,0.834),特异性分别为74.3%(95%CI:0.659,0.817)、74.3%(95%CI:0.824,0.931)。677CT型患者Hcy水平高于677CC、677TT型患者(P<0.05)。结论心房颤动、MTHFR基因型、入院时NIHSS评分、Hcy均为影响脑梗死患者阿替普酶静脉溶栓后HT发生的重要因素,临床应结合以上指标对高危患者进行重点筛查,尽早采取干预措施。

黑龙江地区老年脑梗死患者CYP2C19基因多态性对氯吡格雷疗效的影响

目的探讨黑龙江地区脑梗死患者接受氯吡格雷治疗时CYP2C19基因多态性对治疗效果的影响。方法选取2022年1—12月在黑龙江省医院神经内科住院的90例脑梗死患者为研究对象。检测CYP2C19基因多态性,根据检测结果,将患者分为3组,快代谢组(n=26)、中等代谢组(n=52)和慢代谢组(n=12)。所有患者均给予氯吡格雷治疗,对美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分及预后情况进行观察对比。结果在脑梗死患者中以快代谢型和中等代谢型为主要类型。治疗2周后,3组NIHSS评分低于治疗前,差异有统计学意义(P<0.05);且快代谢组评分为(6.23±1.38)分,低于中等代谢组、慢代谢组的(7.76±1.71)分、(10.12±1.29)分,差异有统计学意义(P<0.05);快代谢组和中等代谢组预后良好率高于慢代谢组(P<0.05);快代谢组、中等代谢组和慢代谢组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论通过对老年脑梗死患者行CYP2C19基因型检测来评估对氯吡格雷治疗的药物代谢能力和反应情况。有助于制定个体化的治疗方案,提高治疗效果并降低不良反应的发生率,可以最大限度地提高治疗效果,减少风险发生。

三酰甘油与APOE基因多态性在短暂性脑缺血发作患者发生急性脑梗死中的交互作用研究

目的探讨三酰甘油(TG)与载脂蛋白E(APOE)基因多态性在短暂性脑缺血发作(TIA)患者发生急性脑梗死中的交互作用。方法对2019年1月—2021年6月349例TIA进行6个月随访,根据是否发生急性脑梗死分为发生组、未发生组,比较2组一般资料、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、TG、APOE基因多态性,并比较不同TG水平患者APOE基因多态性,使用多因素Logistic回归分析TIA发生急性脑梗死的影响因素,使用交互作用系数γ分析TG与APOE基因多态性的交互作用。结果随访6个月,共45例(12.89%)TIA患者发生急性脑梗死。发生组TG高于未发生组(P<0.01)。发生组及TG升高患者E3/3基因型、ε3等位基因频率分别低于未发生组及TG正常患者,E3/4基因型、ε4等位基因频率分别高于未发生组及TG正常患者(P<0.05)。校正TIA持续时间、TIA发作频率后,TG、APOE基因型E3/3、E3/4及等位基因ε4仍是TIA发生急性脑梗死的独立影响因素(P<0.01)。TG升高与APOE基因型E3/4在TIA发生急性脑梗死中呈正向交互作用,且交互作用符合次相乘模型。结论TG升高与APOE基因型E3/4在TIA发生急性脑梗死中呈正向交互作用,且交互作用符合次相乘模型,TG升高可增强APOE基因型E3/4对TIA发生急性脑梗死的易感性。

CYP2C19基因多态性、血清NT-proBNP水平与急性脑梗死静脉溶栓预后不良的关系

目的探讨CYP2C19基因多态性、血清N末端B型脑利钠肽前体(NT-proBNP)水平与急性脑梗死(ACI)患者静脉溶栓预后不良的关系。方法选择210例ACI患者,均行阿替普酶静脉溶栓治疗,治疗90 d后根据改良Rankin量表(mRS)评分将患者分为预后不良组(mRS评分≥3分)52例、预后良好组(mRS评分<3分)158例。治疗前采用实时荧光定量PCR法检测CYP2C19基因多态性,时间分辨荧光免疫层析法检测血清NT-proBNP。用Pearson或Spearman分析CYP2C19基因多态性、血清NT-proBNP水平与mRS评分的相关性;用多因素Logistic回归分析ACI患者静脉溶栓预后的影响因素;用受试者工作特征曲线分析CYP2C19基因多态性、血清NT-proBNP水平对ACI患者静脉溶栓预后不良的预测价值。结果预后不良组年龄、高血压比例、糖尿病比例、入院美国国立卫生研究所脑卒中(NIHSS)评分、空腹血糖水平高于预后良好组(P均<0.05)。预后不良组和预后良好组CYP2C19基因多态性比较差异有统计学意义(P<0.05),预后不良组血清NT-proBNP水平高于预后良好组(P<0.05)。ACI患者CYP2C19基因多态性(r_(s)=0.362)、血清NT-proBNP水平(r=0.426)与mRS评分均呈正相关(P均<0.05)。高NIHSS评分、CYP2C19基因慢代谢型、高血清NT-proBNP水平是ACI患者预后不良的危险因素(P均<0.05)。CYP2C19基因多态性、血清NT-proBNP水平单独及联合预测ACI患者静脉溶栓预后的曲线下面积分别为0.752、0.786、0.861,二者联合预测的曲线下面积高于单独预测(P均<0.05)。结论CYP2C19基因多态性和高水平NT-proBNP是ACI患者静脉溶栓预后不良的危险因素,二者联合对不良预后有较高的预测价值。