【摘要】 目的 探讨Hcy及亚甲基四氢叶酸还原酶(MTHFR) C677T基因多态性与急性腔隙性脑梗死的相关性。方法 选取2017年1月至2018年6月在台州市立医院住院患者及同期健康体检者共278例,分为观察组(146例)和健康对照组(132例),应用聚合酶链反应(PCR)及TaqMan探针技术对MTHFR C677T进行基因分型检测。结果 两组间的收缩压(SBP)、舒张压(DBP)、空腹血糖(FBS)、总胆固醇(TC)、甘油三酯(TG)差异有统计学意义(P<0.05);年龄、性别、尿酸(UA)、血清低密度脂蛋白胆固醇(LDL-C)、血清高密度脂蛋白胆固醇(HDL-C)、叶酸、Hcy差异无统计学意义(P>0.05)。两组间的基因型和等位基因频率分布差异无统计学意义(P>0.05)。观察组携带TT型Hcy水平高于携带CC型及CT型的Hcy水平;对照组携带TT型Hcy水平高于携带CC型及CT型的Hcy水平,差异有统计学意义(P<0.001)。MTHFR C677T与叶酸(r=0.293,β=-1.381,t=-4.591,P<0.001)、Hcy (r=0.332,β=2.966,t=5.481,P<0.001)存在线性回归关系。Logistic回归分析示MTHFR C677T等位基因T、高血压、冠心病、颈动脉斑块是急性腔隙性脑梗死的独立危险因素。结论 Hcy与急性腔隙脑梗死的发病无关;MTHFR C677T基因多态性与急性腔隙性脑梗死的发病相关。更多还原

【Abstract】 Objective To investigate the association between homocysteine,MTHFR C677 T polymorphism and acute lacunar infarction.Methods 146 patients who were admitted into the Taizhou Municipal Hospital from January 2017 and June 2018 were enrolled as acute lacunar infarction group,and 132 healthy individuals who received physical examination in the same hospital and period were also enrolled as control group.Genotyping was completed by the polymerase chain reaction(PCR) and TaqMan probe technique.Results Control group and acute lacunar infarction group were significantly different(P<0.05) in SBP,DBP,FBS,TC and TG the two groups were not significantly different(P>0.05) in age,gender,UA,LDL-C,HDL-C,folic acid and Hcy.The two groups were not significantly different(P>0.05) in genotype distribution and allele frequency.Individuals with the TT genotype had higher homocysteine levels than those with the CC and CT genotype in two groups.Univariate linear regression analysis showed that polymorphism of MTHFR C677 T had linear regression relation with folic acid(r=0.293,P=-1.381,t=-4.591,P<0.001) and Hcy(r=0.332,β=2.966,r=5.481,P<0.001).Logistic regression analysis showed that the T allele of MTHFR C677 T,hypertension,coronary heart disease,carotid plaque were independent risk factors for acute lacunar infarction.Conclusion Hcy is not associated with acute lacunar infarction.Polymorphism of MTHFR C677 T is the risk factor for acute lacunar infarction.更多还原