H型高血压并发缺血性脑卒中患者MTHFR C677T基因多态性及血清Hcy水平的相关性研究

目的 探讨亚甲基四氢叶酸还原酶(MTHFR)基因C677T多态性及血清同型半胱氨酸(Hcy)水平与H型高血压并发缺血性脑卒中的相关性。方法 首先采用病例-对照研究,随机选取491例研究对象,分为对照组(n=111)、缺血性脑卒中组(n=185)、H型高血压并发缺血性脑卒中组(n=195)。其次采用聚合酶链反应-芯片杂交法测定MTHFR基因型,采用循环酶法检测血清Hcy水平,最后通过统计学方法分析基因型在不同组间的分布情况,以及不同基因型患者的Hcy水平。结果各实验组和对照组相比,MTHFR基因型分布差异均具有统计学意义(χ2=7.45～10.748,均P<0.05)。等位基因T频率和对照组比较,差异均具有统计学意义(χ2=4.343～9.886,均P<0.05)。而H型高血压并发缺血性脑卒中组和缺血性脑卒中组比较,MTHFR基因型分布差异无统计学意义(χ2=2.668,P=0.263)。各实验组TT型Hcy水平明显高于CT型和CC型,差异具有统计学意义(F=8.503～10.659,均P<0.05)。缺血性脑卒中组及H型高血压并发缺血性脑卒中组的Hcy水平(16.87±9.04,21.63±14.09 μmol/L)均高于对照组Hcy水平(10.76±2.44 μmol/L),差异具有统计学意义(F=37.942,P<0.001)。H型高血压并发缺血性脑卒中组的Hcy水平(21.63±14.09 μmol/L)高于缺血性脑卒中组Hcy水平(16.87±9.04 μmol/L),差异具有统计学意义(F=37.942,P<0.001)。结论 MTHFR基因多态性和血清高Hcy水平均可能为缺血性脑卒中的危险因素。对于H型高血压患者,更应注意在降压同时补充叶酸,以降低H型高血压患者缺血性脑卒中的发生率。

Relationship between MTHFR C677T Gene Polymorphismsand Serum Hcy Level in H Type Hypertension with Ischemic Stroke

Objective To study the correlation between themethylenetetrahydrofolate reductase(MTHFR)gene C677T polymorphism and serum homocysteine(Hcy)level in H type hypertension with ischemic stroke.Methods Firstly,a case-control study was performed in the control group(n=111),the ischemic stroke group(n=185),the H type hypertension with ischemic stroke group(n=195).Secondly,MTHFR C677T polymorphism was determined by PCR chip-hybridization and serum Hcy was determined by circulating enzymatic.Lastly,statistical analysis was performed with SPSS25.0.The genotype and the serum Hcy was compared.Results There wassignificant difference in MTHFR genotype between case groups and control group(χ²=7.45～10.748,all P<0.05).There was significant difference inthe frequency of T alleles between case groups and control group(χ²=4.343～9.886,all P<0.05).There was no significant difference of MTHFR between H type hypertension with ischemic stroke group and ischemic stroke group(χ2=2.668,P=0.263).The level of TT genotype serum Hcy was higher than CT genotype andCC genotype in all case groups(F=8.503～10.659,P<0.05).The Hcy level of ischemic stroke group and H type hypertension with ischemic stroke group were(16.87±9.04 μmol/L)and(21.63±14.09 μmol/L)respectively,which were both significantly higher than that of the control group(10.76±2.44 μmol/L)(F=37.942,P<0.001).There was significant difference in the Hcy level between H type hypertension with ischemic stroke group(21.63±14.00 μmol/L)and ischemic stroke group(16.87±9.04 μmol/L)(F=37.942,P<0.001).Conclusion Both MTHFR gene polymorphism and high serum Hcy level might be the risk factors for ischemic stroke.For H type hypertension patients,more attention should be paid to reducing blood pressure andsupplementing folic acid in order to reduce the incidence of ischemic stroke.