【摘要】 目的分析研究LPA+93C>T基因多态性与Lp(a)水平及不同亚型脑梗死的关系。方法选取2007-12~2008-10间在中山大学附属第三医院神经内科住院治疗的150例大动脉粥样硬化性脑梗死(Large-Artery Atherosclerosis,LAA)患者和175例小血管闭塞性脑梗死(Small-Artery occlusion,SAO)患者作研究对象,与245例体检患者进行对照。采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析LPA+93位点的基因型。应用酶联免疫吸附试验(ELISA)测定血浆Lp(a)浓度。结果研究组(LAA组及SAO组)血浆Lp(a)中位数显著高于对照组。无论LAA组、SAO组还是对照组,携带突变LPA+93T等位基因者血浆LP(a)水平较非携带者显著降低。在LAA组中携带+93T等位基因的LPA频率显著低于对照组(OR=0.58,95%CI=0.38~0.87,P=0.008),而SAO组与对照组比较无统计学差异(P=0.6)。但经多元显回归分析显示,携带+93T等位基因的LPA对减少LAA发病风险无统计学意义(OR=0.78,95%CI=0.43~1.47,P=0.42)。结论我们的研究结果支持高水平Lp(a)是LAA同时也是SAO独立危险因素。携带突变LPA+93T等位基因者血浆LP(a)水平较非携带者显著降低,但不能减少LAA发病风险。更多还原

【Abstract】 Objective To analyze the relationship of LPA + 93 C > T gene polymorphism and LP( a) level and cerebral infarction of different subtypes. Methods Selecting a total of 325 consecutive patients with a diagnosis of ischemic stroke admitted to the department of neurology in the Third Affiliated Hospital of Sun Yat- sen University including 150 patients with LAA and 175 patients with SAO. 245 patients under physical examination were in the control group. Genotyping of the LPA C93 T polymorphism was performed by means of PCR-RFLPs. Plasma Lp( a) was tested by ELISA. Results Median Lp( a) levels were significantly higher in patients with LAA and SAO than in control subjects. Subjects carrying at least one LPA + 93 T allele had lower Lp( a) levels. The prevalence rate of the 93 T allele was significantly higher in control subjects than in LAA patients,but there was no significant differences in allele frequencies of LPA between SAO patients and control subjects( P = 0. 6). In multivariate logistic regression analysis with covariates including traditional risk factors,the 93 T allele was not independently associated with a reduced risk of LAA( OR = 0. 78,95% CI = 0. 43 ~ 1. 47,P = 0. 42). Conclusion The results support the hypothesis that elevated Lp( a) is an independent risk factor for ischemic stroke caused by both LAA and SAO. The 93 T allele of the LPA gene is associated with low Lp( a) levels,but may not be an independent low risk for LAA.更多还原