PTGS1基因多态性与急性脑梗死患者阿司匹林抗血栓疗效的相关性

目的 探讨前列腺素内过氧化物合酶1(Prostaglandin-endoperoxide synthase1, PTGS1)基因多态性与急性脑梗死患者阿司匹林抗血栓疗效的相关性。方法 回顾性分析2017年10月-2020年10月在本院接受治疗的200例急性脑梗死患者的临床资料,按照其阿司匹林抗血栓疗效将其分为阿司匹林抵抗组(n=69)和阿司匹林敏感组(n=131),分析所有患者PTGS1基因多态性情况,比较2组性别、年龄、身体质量指数(Body Mass Index,BMI)、合并症(高血压病、冠心病、糖尿病)、PTGS1基因突变、不良嗜好(吸烟、酗酒)等临床特征及生化指标血小板计数(Blood platelet,PLT)、超敏C反应蛋白(Hypersensitive-C reactive protein,hs-CRP)]水平,利用受试者工作特征(Receiver operating characteristic,ROC)曲线分析PLT,hs-CRP预测急性脑梗死患者阿司匹林抵抗的价值,将2组有差异的指标纳入Logistic回归分析模型,进行量化赋值,明确引起急性脑梗死患者阿司匹林抵抗的危险因素。结果 本研究200例急性脑梗死患者中PTGS1基因位点以AA为主,发生率为81.50%,其突变基因位点分别为AG,GG,占人数的14.00%、4.50%。阿司匹林抵抗组年龄≥60岁、合并糖尿病、PTGS1基因突变、吸烟患者的比例及PLT,hs-CRP水平显著高于阿司匹林敏感组(P<0.05)。经ROC曲线分析PLT,hs-CRP预测急性脑梗死患者阿司匹林抵抗的曲线下面积分别为0.879、0.866。年龄≥60岁、合并糖尿病、PTGS1基因突变、吸烟、PLT≥202.255×10⁹/L,hs-CRP≥24.695 mg/L是引起急性脑梗死患者阿司匹林抵抗的危险因素。结论 PTGS1基因多态性会增加急性脑梗死患者阿司匹林抵抗风险。除此之外,高龄、糖尿病、抽烟及PLT,hs-CRP异常高表达均可能影响阿司匹林抗血栓治疗效果。

Correlation between ptgs1 gene polymorphism and the antithrombotic effect of aspirin in patients with acute cerebral infarction

Objective To study the relationship between the polymorphism of prostaglandin endoperoxide synthase 1(ptgs1)gene and the antithrombotic effect of aspirin in patients with acute cerebral infarction.Methods 200 patients with acute cerebral infarction admitted to our hospital from October 2017 to October 2020 were selected for study. According to the antithrombotic effect of aspirin, they were divided into aspirin resistant group(n=69)and aspirin sensitive group(n=131). The ptgs1 gene polymorphism of all patients was analyzed, and the clinical characteristics, including gender, age, body mass index(BMI), complications(hypertension, coronary heart disease, diabetes), ptgs1 gene mutation, habits(smoking, drinking), and biochemical indexes(platelet count(PLT), high sensitivity C-reactive protein(hsCRP))of the two groups were compared, Receiver operating characteristic(ROC)was used to analyze the value of PLT and hs CRP in order to predict aspirin resistance in patients with acute cerebral infarction. The difference information between the two groups was included in the logistic regression analysis model for quantitative evaluation, and the risk factors of aspirin resistance in patients with acute cerebral infarction were identified.Results In 200 patients with acute cerebral infarction, the ptgs1 gene locus was mainly AA, the incidence was 81.50%, and the mutant gene loci were Ag and GG, accounting for 14.00% and 4.50% respectively. The proportion of patients with age ≥60 years, diabetes mellitus, ptgs1 gene mutation, smoking, high PLT and hsCRP levels in aspirin resistance group were significantly higher than those in aspirin sensitive group(P<0.05). ROC analysis showed that the area under the curve of PLT and hsCRP in predicting aspirin resistance in patients with acute cerebral infarction were 0.879 and 0.866, respectively. Age≥60 years, diabetes mellitus, ptgs1 gene mutation, smoking, PLT≥202.255×10⁹/L and hs CRP≥24. 695 mg/L were risk factors of aspirin resistance in patients with acute cerebral infarction.Conclusion The ptgs1 gene polymorphism may increase the risk of aspirin resistance in patients with acute cerebral infarction. In addition, age, diabetes history, smoking history and abnormal expression of PLT and hs CRP may affect the effect of aspirin antithrombotic therapy.