海南医科大学学报

目的:研究脑梗死复发患者亚甲基四氢叶酸还原酶(MTHFR)多态性与同型半胱氨酸(Hcy)代谢、炎症反应的相关性。方法:选择2013年12月~2016年12月在榆林市第三医院就诊的40例复发性脑梗死患者作为复发组、58例初发性脑梗死作为初发组,体检的60例健康志愿者作为对照组,检测外周血中MTHFR基因C677T多态性以及血清中Hcy代谢指标、炎症反应指标的含量。结果:复发组患者CC基因型的构成比显著低于初发组和对照组,CT基因型、TT基因型的构成比显著高于初发组和对照组(P<0.05);复发组和初发组患者血清Hcy、高迁移率族蛋白B(HMGB)1、sCD40L、YKL-40、Lp-PLA2、基质金属蛋白酶(MMP)-9的含量均显著高于对照组(P<0.05),VitB1 2、叶酸(FA)含量均显著低于对照组(P<0.05);复发组患者血清中Hcy、HMGB1、sCD40L、YKL-40、Lp-PLA2、MMP-9的含量均显著高于初发组(P<0.05),VitB1 2、FA的含量均显著低于初发组(P<0.05)。CC基因型患者血清中Hcy、HMGB1、sCD40L、YKL-40、Lp-PLA2、MMP-9的含量显著低于CT基因型、TT基因型患者(P<0.05),VitB1 2、FA的含量均显著高于CT基因型、TT基因型(P<0.05);CT基因型患者血清中Hcy、HMGB1、sCD40L、YKL-40、Lp-PLA2、MMP-9的含量显著低于TT基因型患者(P<0.05),VitB1 2、FA的含量均显著高于TT基因型(P<0.05)。结论:MTHFR基因C677T多态性与脑梗死复发密切相关,等位基因C向T突变会影响Hcy代谢、加重炎症反应。

Objective:To study the correlation of methylenetetrahydrofolate reductase(MTHFR)polymorphism with Hcy metabolism and inflammatory response in patients with recurrent cerebral infarction.Methods:A total of 40 patients with recurrent cerebral infarction who were treated in The Third Hospital of Yulin City between December 2013 and December 2016 were selected as recurrent group,58 patients with primary cerebral infarction were selected as primary group,and 60 healthy volunteers were selected as control group.Peripheral blood MTHFR gene C677 Tpolymorphism and serum levels of Hcy metabolism indexes and inflammatory response indicators were determined.Results:CC genotype constituent ratio of recurrent group was significantly lower than that of primary group and control group while CT genotype and TT genotype constituent ratio were significantly higher than those of primary group and control group(P<0.05);serum Hcy,HMGB1,sCD40 L,YKL-40,Lp-PLA2 and MMP-9levels in recurrent group and primary group were significantly higher than those in control group while VitB1 2and FA levels were significantly lower than those in control group(P<0.05);serum Hcy,HMGB1,sCD40 L,YKL-40,Lp-PLA2 and MMP-9levels in recurrent group were significantly higher than those in primary group while VitB1 2and FA levels were significantly lower than those in primary group(P<0.05).Serum Hcy,HMGB1,sCD40 L,YKL-40,LpPLA2 and MMP-9levels in patients with CC genotype were significantly lower than those in patients with CT genotype and TT genotype while VitB1 2and FA levels were significantly higher than those in patients with CT genotype and TT genotype(P<0.05);serum Hcy,HMGB1,sCD40 L,YKL-40,Lp-PLA2 and MMP-9levels in patients with CT genotype were significantly lower than those in patients with TT genotype while VitB1 2and FA levels were significantly higher than those in patients with TT genotype(P<0.05).Conclusions:MTHFR gene C677 Tpolymorphism is closely related to the recurrence of cerebral infarction,and allele C mutated to T will affect Hcy metabolism and aggravate inflammatory response.