炎症因子基因与缺血性脑卒中患者预后的相关性分析

目的探讨炎症因子MCP-1、CCR2、E-selectin基因多态性与缺血性脑卒中患者预后之间的相关性。方法采用病例对照研究方法,选取2014年10月-2016年10月于本院连续住院的缺血性脑卒中患者200例作为观察组,均经计算机断层扫描(CT)、磁共振成像(MRI)明确诊断,同期选择本院健康体检者200例作为对照组,接受问卷调查、体格检查、采集血标本。抽取患者外周静脉血并提取DNA,采用Sequenom Massyarray技术检测单核细胞趋化蛋白-1(MCP-1)(rs1024611、rs3760396)、C-C趋化因子受体2 (CCR2)(rs1799864、rs1799865)、E-selectin (rs2076059、rs10800469、rs3917412、rs5368)的基因型。由经过统一培训的医护人员在缺血性脑卒中发病90 d后进行随访,记录改良Rankin评分(mRS)。采用Logistic回归分析评价各基因型与脑卒中预后之间的关系。结果在缺血性脑卒中患者中,E-selectin的rs2076059基因型和等位基因频率与对照组相比差异具有统计学意义(P <0. 05)。缺血性脑卒中患者E-selectin的rs2076059基因型多态性显著增加,MCP-1、CCR2基因的单核苷酸多态性(SNP)之间没有显著关联。经回归分析发现E-selectin基因rs2076059位点也是缺血性脑卒中发病的独立危险因素。根据mRS评分,E-selectin基因rs2076059位点G/A基因型携带者较G/G基因型患者发生预后不良的相对风险度为2.17(P=0.007,OR=2.17,95%CI:1.48～5.79)。结论E-selectin基因rs2076059位点是缺血性脑卒中发病的独立危险因素; rs2076059位点与缺血性脑卒中的预后有关;相较于G/G基因型,G/A基因型为风险基因型,更易导致缺血性脑卒中预后不良。

Correlations Between Gene Polymorphisms of Inflammatory Factors and Prognosis of Patients with Ischemic Stroke

Objective To investigate the correlations between the polymorphisms of inflammatory genes(MCP-1,CCR2 and E-selectin)and the prognosis of ischemic stroke patients.Methods Using case-control study,200 consecutive patients with ischemic stroke hospitalized between October 2014 and October 2016 were selected as the observation group.All the ischemic stroke patients were diagnosed by computed tomography(CT)and magnetic resonance imaging(MRI).During the same period,another 200 health examinees in our hospital were selected as the control group.Questionnaires were distributed,physical examinations organized and blood samples were collected.DNA was extracted from peripheral venous blood of patients.The genotypes of monocyte chemoattractant protein-1(MCP-1)(rs1024611,rs3760396),C-C chemokine receptor 2(CCR2)(rs1799864,rs1799865)and E-selectin(rs2076059,rs10800469,rs3917412,rs5368)were detected by Sequenom Massyarray technique.The patients were followed up for 90 days after the onset of ischemic stroke by uniformly trained doctors and nurses,and the modified Rankin Scale(mRS)scores were recorded.Logistic regression analysis was used to evaluate the association between genotypes and prognosis of stroke.Results The genotype and allele frequencies of E-selectin rs2076059 in patients with ischemic stroke were significantly different from those in the control group(P<0.05).The genotype diversity of rs2076059 in E-selectin increased significantly in patients with ischemic stroke,but there was no significant correlation between single nucleotide polymorphism(SNP)of MCP-1 and CCR2 genes.Regression analysis showed that E-selectin gene rs2076059 was also an independent risk factor for ischemic stroke.According to the mRS score,the relative risk of poor prognosis of G/A genotype carriers at rs2076059 locus of E-selectin gene was 2.17(P=0.007,OR=2.17,95%CI:1.48~5.79)compared with G/G genotype carriers.Conclusion The rs2076059 locus of E-selectin gene is an independent risk factor for ischemic stroke.The rs2076059 locus is associated with the prognosis of ischemic stroke.Compared with G/G genotype,G/A genotype is a risk genotype,which is more likely to lead to poor prognosis of ischemic stroke.