首页|口腔黏膜脱落细胞用于高血压患者MTHFR C677T基因突变快速检测的有效性和安全性研究

口腔黏膜脱落细胞用于高血压患者MTHFR C677T基因突变快速检测的有效性和安全性研究

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目的 研究使用荧光探针法床边快速检测口腔黏膜脱落细胞标本亚甲基四氢叶酸还原酶(MTHFR)C677T基因型的准确率和安全性。方法 选取2019年1月至2020年9月间就诊于十堰市太和医院心血管内科的门诊和住院高血压患者,患者均在实验室检测血浆同型半胱氨酸(Hcy)水平,选取Hcy≥10μmol/L的高血压患者共482例,患者均采集口腔黏膜细胞及全血标本,分别用口腔黏膜脱落细胞荧光探针法及全血标本对比试剂检测上述标本MTHFR C677T基因型,若两者检测结果不一致则使用"金标准"Sanger测序法检测全血标本对MTHFR C677T基因型进行最终判定。比较两种检测方法的符合率并观察记录采集标本过程中发生不良事件的概率,评价荧光探针法检测患者口腔黏膜脱落细胞MTHFR C677T基因型的准确率和安全性。结果 482例高血压患者口腔黏膜脱落细胞标本和全血标本成功完成采集,且采样过程中患者未发生明显不良反应。荧光探针法和对比试剂检测MTHFR C677T基因总突变发生率为73。23%(353/482),两种方法检测MTHFR C677T基因纯合野生型(CC型)符合率为100。00%(95%CI:97。11~100。00),杂合突变型(CT型)符合率为99。14%(95%CI:96。91~99。76),纯合突变型(TT型)符合率为99。17%(95%CI:95。47~99。85),MTHFR C677T基因型总符合率为99。38%(95%CI:98。19~99。79),检测结果一致性Kappa值为0。9902。结论 采集口腔黏膜脱落细胞使用荧光探针法检测MTHFR C677T基因突变操作简便、创伤小,且快速、安全、准确。
Study on efficacy and safety of oral mucosal exfoliated cells used in rapid detection of MTHFR C677T gene mutation in patients with hypertension
Objective To study the accuracy and safety of oral mucosal exfoliated cell specimens used in the bedside rapid detection of MTHFR C677T genotype by using the fluorescent probe method.Methods The outpatients and inpatients with hypertension visited and admitted in the department of cardiovascular medicine of this hospital from January 2019 to September 2020 were selected.The plasma homocysteine (Hcy) level in all patients was detected in the laboratory,a total of 482 hypertensive patients with Hcy≥10 μmol/L were se-lected,and the oral mucosal cells and whole blood sample were collected in all patients,and the genotypes of the above specimens were detected by the oral mucosal exfoliative cell fluorescent probe method and whole blood sample contrast reagents.If the two test results were inconsistent,the "gold standard" Sanger sequen-cing method was used to detect the whole blood sample for the final determination of MTHFR C677T geno-type.The coincidence rate was compared between the two detection methods,and the probability of adverse e-vents during the samples collection was observed and recorded.The accuracy and safety of fluorescence probe method for detecting MTHFR C677T genotype in the patients with oral mucosa exfoliation was evaluated.Re-sults The oral mucosal exfoliated cell samples and whole blood samples from 482 hypertensive patients were successfully collected,and no obvious adverse reactions occurred during the sampling process.The incidence rate of total mutation of MTHFR C677T gene detected by the fluorescence probe method and contrast reagent all were 73.23% (353/482),the coincidence rate of homozygous wild type (CC type) in MTHFR C677T gene detected by the two methods was 100.00% (95%CI:97.11-100.00),which of heterozygous mutant type (CT type) was 99.14% (95%CI:96.91-99.76),which of homozygous mutant type (TT type) was 99.17%(95%CI:95.47-99.85),the total coincident rate of MTHFR C677T genotype was 99.38% (95%CI:98.19-99.79)and the detection results consistency Kappa value was 0.9902.Conclusion The detection of MTHFR C677T gene mutation in oral mucosal exfoliated cells by fluorescent probe method is simple with less invasion,moreover which is rapid,safe and accurate.

methylenetetrahydrofolate reductasegene polymorphismsfluorescent probe rapid detectionSanger sequencing method

余将丽、高必贞、党书毅、王俊峰、魏云杰、周港彦、董晓

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湖北医药学院附属医院/十堰市太和医院心血管疾病诊疗中心,湖北十堰 442000

亚甲基四氢叶酸还原酶 基因多态性 荧光探针法快速检测 Sanger测序法

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(14)