【摘要】 目的探讨血清基质金属蛋白酶9(MMP-9)水平及基因-1562C>T多态性与维吾尔族缺血性脑卒中(IS)及其各亚组的关系。方法采用病例对照研究,选择维吾尔族急性IS患者284例。按新的急性脑卒中治疗(TOAST)分型分为动脉粥样硬化血栓形成(AT)组91例、小动脉病变(SAD)组150例和心源性脑栓塞(CE)组43例;选择同期健康体检者226例为对照组。采用酶联免疫吸附法检测血清MMP-9水平,聚合酶链反应-限制性片段长度多态性技术检测MMP-9基因-1562C>T的基因型。结果 IS组血清MMP-9水平显著高于对照组(0.308±0.033mg/L比0.087±0.011 mg/L,t=7.813,P=0.000),且AT组、CE组显著高于SAD组(0.350±0.030 mg/L比0.261±0.029 mg/L,t=4.156,P=0.001;0.317±0.043 mg/L比0.261±0.029 mg/L,t=2.877,P=0.031)。多变量Logistic回归分析显示,血清MMP-9水平增高是IS的独立危险因素(OR:1.012,95%CI:1.007~1.016,P<0.01)。IS组基因型(χ2=3.558,P=0.058)和等位基因(χ2=3.567,P=0.059)频率与对照组无显著性差异。AT组和对照组之间基因型(χ2=5.097,P=0.024)和等位基因(χ2=5.439,P=0.02)频率存在显著差异,其中AT组CT+TT基因型频率显著高于对照组(24.2%比13.7%)。多变量Logistic回归分析显示,MMP-9基因-1562C>T多态性并非是缺血性脑卒中的独立危险因素(OR:0.821,95%CI:0.622~1.059,P=0.124),但却是AT的独立危险因素(OR:1.768,95%CI:1.178~2.677,P=0.007)。结论维吾尔族IS患者血浆MMP-9水平增高,以AT亚组增高最为显著;MMP-9基因-1562C>T多态性与维吾尔族人群IS的发生无明显相关性,但可能与AT型脑卒中相关。更多还原

【Abstract】 Aim To investigate the correlation of matrix metalloproteinase-9( MMP-9) levels and MMP-9- 1562C > T polymorphism with acute ischemic stroke( IS) and its "Trial of Org 10172 in Acute Stroke Treatment"( TOAST) subtypes in Uygur nationality. Methods A total of 284 patients with acute IS were enrolled using the method of case-control study,based on the standard of new TOAST classification,91 patients were atherothrombosis( AT),150 patients were small artery disease( SAD) and 43 patients were cardioembolism( CE). Meanwhiie,226 age-and sexmatched physically healthy subjects were used as control group. The levels of serum MMP-9 and- 1562C > T gene polymorphism in each group were measured and analyzed by enzyme-linked immunosorbent assay and restriction fragment length polymorphism. Results The serum MMP-9 level in the IS group was sigrfificantly higher than that in the control group( 0. 308 ±0. 033 mg/L vs 0. 087 ±0. 011 mg/L,t =7. 813,P =0. 000). The serum MMP-9 level in the AT group and CE group were significantly higher than those in the groups of SAD( 0. 350 ± 0. 030 mg / L vs 0. 261 ± 0. 029 mg / L,t = 4. 156, P = 0. 001; 0. 317 ± 0. 043 mg / L vs 0. 261 ± 0. 029 mg / L,t = 2. 877,P = 0. 031). Multivariate Logistic regression analysis showed that the increased serum MMP-9 level was an independent risk factor for ischemic stroke( OR: 1. 012,95% CI: 1. 007 ~ 1. 016,P < 0. 001). There was no significant difference in the frequencies of genotype( χ2= 3. 558,P = 0. 058) and allele( χ2= 3. 567,P = 0. 059) of MMP-9- 1562C > T between the IS group and the control group. However,there were significant difference in the frequencies of genotype( χ2= 5. 097,P = 0. 024) and allele( χ2= 5. 439,P = 0. 02) of MMP-9- 1562C > T between the AT group and the control group. The CT + TT genotype frequency in the AT group was significantly higher than the control group( 24. 2% vs 13. 7%). Multivariate Logistic regression analysis showed that MMP-9- 1562C > T polymomhism was not an independent risk factor for the IS group( OR: 0. 821,95% CI: 0. 622 ~ 1. 059,P = 0. 124),but it was an independent risk factor for the AT group( OR: 1. 768,95% CI: 1. 178 ~ 2. 677,P = 0. 007). Conclusions The serum MMP-9 level increased in Uygur patients with IS,especially in the patients with AT. The- 1562C > T polymorphism of MMP-9 gene might be associated with AT in this studied population.更多还原