大连地区汉族脑卒中患者内皮细胞一氧化氮合酶基因多态性与缺血性脑卒中的相关性

背景目前国内外在已研究的数个缺血性脑血管病的候选基因中,尚未发现肯定的致病基因.内皮源性一氧化氮合酶(endothelial consititutive nitric oxide synthase,ecNOS)基因多态性与缺血性脑卒中是否存在相关性?目的通过大连地区汉族脑血管病患者 ecNOS基因多态性进行分析,探讨ecNOS基因多态性与缺血性脑卒中的关系. 设计以诊断为依据的病例对照研究.地点和对象 2001-12/2002-12大连医科大学附属第一临床学院神经内科住院急性缺血性脑卒中患者170例(缺血性脑卒中组),本组又分为 4个亚组大血管动脉硬化性血栓形成组108例,腔隙性脑梗死组 30例,原因不明及心源性脑栓塞组 18例,短暂性脑缺血发作组14例.对照组为 90例健康体检者及同期住院的非脑血管病患者.主要观察指标两组患者既往发生高血压、冠心病、糖尿病情况,吸烟情况、血清中总胆固醇、三酰甘油、纤维蛋白原含量、颈内动脉彩色超声检查以及ecNOS基因类型. 结果在缺血性脑卒中组中,既往有原发性高血压病史者占66.3% (112/170),糖尿病史者占 38.2% (65/170),吸烟者占 44.2% (75/170),纤维蛋白原含量为(3.70± 0.63) g/L、颈内动脉狭窄占 53.5% (91/170)与对照组 [23.8% (21/90),9.5%(8/90),19.0% (17/90),(3.44 ± 0.32) g/L,19.0% (17/90)]比较,差异有显著性意义(P< 0.05),其余各项指标分布差异无显著性意义.非条件性 Logistic回归分析证实,ecNOS基因多态性不是缺血性脑卒中的独立危险因素. 结论 ecNOS4a/b基因多态性与大连地区汉族人缺血性脑卒中无相关性.

Association between endothelial constitutive nitric oxide synthase gene polymorphism and ischemic stroke in Han patients in Dalian

BACKGROUND:Among the several candidate genes for ischemic cerebral vascular diseases(ICVD) that have been studied both domestically and abroad, none has been identified as the definite gene responsible for such diseases.Currently whether endothelial constitutive nitric oxide synthase(ecNOS) gene polymorphism is related to ischemic stroke remains unknown. OBJECTIVE:To explore the relationship between ecNOS gene polymorphism and ischemic stroke in patients of Han nationality in Dalian. DESIGN:A diagnosis-based case-control study. SETTING and PARTICIPANTS:A total of 170 inpatients with acute ischemic stroke admitted between December 2001 and December 2002 in the Department of Neurology,the First Affiliated Hospital of Dalian Medical University,were selected for this study and divided into four subgroups, including atherosclerotic thrombosis group(n=108),lacunar cerebral infarction group(n=30),cardiogenic and uncertain stroke group(n=18),and transient ischemic attack(TIA) group(n=14).Another 90 healthy subjects or non-CVD patients were also enrolled as the control group. MAIN OUTCOME MEASURES:The subjects in these groups were examined for the occurrence of hypertension, coronary heart disease, diabetes mellitus,smoke,serum total cholesterol,triglyceride,fibrinogen content,color Dopplar of internal carotid artery and ecNOS genotype. RESULTS:In the ischemic stroke group, the occurrences of hypertension[66.3% (112/170)],diabetes mellitus[38.2% (65/170)], smoking[44.2% (75/170)],fibrinogen content[(3.70± 0.63) g/L],and internal carotid artery stenosis[53.5% (91/170)] were significantly different from those of the control group[23.8% (21/90),9.5% (8/90),19.0% (17/90),(3.44± 0.32) g/L,19.0% (17/90),respectively](P< 0.05),without significant difference in other data(P >0.05).Logistic analysis suggested that ecNOS gene polymorphism was not the independent risk factor for ischemic stroke. CONCLUSION:There is no association between ecNOS4a/b gene polymorphism and cerebral ischemic vascular disease in subjects of Han nationality in Dalian.