趋化因子CXCL16基因rs3744700多态性与脑梗死亚型的相关性研究

目的研究血清趋化因子CXCL16（CXCL16）水平及CXCL16基因rs3744700多态性与急性卒中治疗低分子肝素试验病因分型（TOAST）亚型的关系。方法选择发病≤7 d的动脉粥样硬化性脑梗死患者248例,其中大动脉粥样硬化性脑梗死（LAA）组149例,小动脉闭塞性脑梗死（SAO）组99例。采用聚合酶链式反应（PCR）及基因测序技术检测基因型、酶联免疫吸附法检测血清CXCL16水平。结果①LAA组血清CXCL16水平为（2.5±0.3）μg/L;SAO组为（2.3±0.6）μg/L,P〈0.01。②149例LAA组患者中,CXCL16基因rs3744700多态位点GG基因型频率为91.9%（137/149）,G等位基因频率为96.0%（286/298）,高于SAO组的81.8%及89.9%,差异有统计学意义,P〈0.05。③LAA组GG基因型患者血清CXCL16水平为（2.5±0.3）μg/L,高于GT＋TT基因型患者的（2.1±0.3）μg/L;SAO组GG基因型患者血清CXCL16水平为（2.4±0.6）μg/L,高于GT＋TT基因型患者的（2.1±0.3）μg/L,均P〈0.05。GG基因型患者中,LAA组血清CXCL16水平高于SAO组,P=0.01;GT＋TT基因型患者中两组CXCL16水平差异无统计学意义。④多因素Logistic回归分析显示,血清CXCL16水平（OR=0.37,95%CI：0.19～0.70）、CXCL16基因rs3744700多态位点GG基因型（OR=2.57,95%CI：1.23～5.36）是影响LAA型脑梗死的独立危险因素。结论TOAST亚型中,血清CXCL16水平及CXCL16基因rs3744700多态位点GG基因型与LAA型脑梗死的相关性高于SAO型脑梗死。

Correlation study of CXCL16 gene rs3744700 polymorphisms and cerebral infarction subtypes

Objective To study the correlation between the serum chemokine CXC Ligand 16(CXCL16) levels or the CXCL16 gene rs3744700 polymorphisms and TOAST subtypes in patients with acute cerebral infarction.Methods A total of 248 patients with atherosclerotic cerebral infarction within 7 days after symptom onset were selected,among them 149 patients were in a large artery atherosclerotic(LAA) cerebral infarction group,and 99 patients were in a small arterial occlusive(SAO) cerebral infarction group.The polymerase chain reaction(PCR) and gene sequencing were used to detect the genotypes.An enzyme-linked immunosorbent assay was used to detect the serum CXCL16 levels.Results ①Serum CXCL16 level in the LAA cerebral infarction group was 2.5±0.3 μg/L and in the SAO cerebral infarction group were 2.3±0.6 μg/L(P<0.01).②Among the 149 patients in the LAA cerebral infarction group,the GG genotype frequency at polymorphic loci of CXCL16 gene rs3744700 was 91.9%(137/149) and the G allele frequency was 96.0%(286/298).They were higher than 81.8% and 89.9% in the SAO cerebral infarction group.There were significant differences(P<0.05).③The serum CXCL16 level in patients with CG genotype was 2.5±0.3 μg/L in the LAA cerebral infarction group,ant it was higher than 2.1±0.3 μg/L in patients with GT+TT genotype;the serum CXCL16 level in patients with CG genotype was 2.4±0.6 μg/L in the SAO cerebral infarction group,and it was higher than 2.1±0.3 μg/L in patients with GT+TT 2 genotype(all P<0.01).Among the patients with GG genotype,the serum CXCL16 level in the LAA cerebral infarction group was higher than that in the SAO cerebral infarction group(P=0.01);there was no significant difference in patients with GT+TT genotype between both groups.④Multivariate Logistic regression analysis showed that the serum CXCL16 level(OR=0.37,95%CI 0.19-0.70) and the GG genotype at polymorphic loci of CXCL16 gene rs3744700(OR=2.57,95%CI 1.23-5.36) were the independent risk factors for affecting LAA cerebral infarction.Conclusion In the TOAST subtypes,the correlation of serum CXCL16 level and the GG genotype at polymorphic loci of CXCL16 gene rs3744700 and LAA cerebral infarction are higher than SAO cerebral infarction.