血小板活化因子乙酰水解酶基因多态性与缺血性脑卒中患者血小板活化和预后关系的研究

目的探讨血小板活化因子乙酰水解酶（PAF—AH）基因多态性与缺血性脑卒中的关系。方法应用PCR技术，分析205例缺血性脑卒中患者（脑卒中组）及114例健康体检者（对照组）的基因型。并测定血浆血小板活化因子（PAF）、α颗粒膜糖蛋白140（GMP-140）、β-血小板球蛋白（β-TG）和血小板第4因子（PF4）水平。结果脑卒中组PAF-AH基因突变率和血浆PAF、GMP-140、β—TG和PF4水平[分别为42．44％、（91．08±39．10）ng／L、（36．46±13．10）μg／L、（41．75±11．18）μg／L、（29．05±9．16）μg／L]均显著高于对照组[分别为21．05％、（64．30±18．81）ng/L、（18．27±7．68）μg／L、（30．94±8．47）μg/L、（18．75±6．06）μg／L]（P＜0．01）。脑卒中组基因突变者血浆PAF、GMP．140水平显著高于无基因突变者（P＜0．01）。结论缺血性脑卒中患者急性期血小板活化增强，且与PAF。AH基因多态性相关。PAF-AH基因突变可能是缺血性脑卒中的一种遗传危险标志。

Relationship between platelet activating factor acetylhydrolase genetic polymorphism and platelet activation and prognosis in patients with ischemic stroke

Objective To investigate the corelation between platelet activating factor acetylhydrolase （PAF-AH） genetic polymorphism and ischemic stroke. Methods The plasma PAF-AH genotype was determined in 205 patients with ischemic stroke and 114 normal subjects by the polymerase chain reaction. The levels of plasma platelet activating factor （ PAF ）, platelet α -granule membrane glycoprotein- 140（ GMP-140）.β -thromboglobulin （β -TG） and the levels of platelet factor 4 （PF4） were analyzed. Results The prevalence of the mutation geno±pe and plasma PAF, GMP-140, β-TG and PFd in the patients with ischemic stroke [42.44%,（91.08±39.10） ng/L, （36.46 ± 13.10） μg/L, （41.75 ＋ 11.18） lAg/L, （29.05 ± 9.16 ） μg/L, respectively ] were significantly higher than those in the controls[21.05%,（64.30 ± 18.81 ） ng/L, （ 18.27 ＋ 7.68 ） μg/L, （ 301.94 ＋ 8.47 ） μ g/L, （ 18.75 ± 6.06 ） μ g/L ] （ P 〈 0.01 ）. The levels of plasma PAF,GMP-140 were significantly higher in mutation genotype patients than those in the normal genotype patients （P 〈0.01 ）. Conclusions The activation function of platelet in the acute phase of patients with ischemic stroke increases, and it is associated with genetic polymorphism of PAF-AH. The PAF-AH gene mutation may be a novel genetic marker for high risk of ischemic stroke.