H型高血压急性缺血性脑卒中患者亚甲基四氢叶酸还原酶C677T基因多态性及其与肾功能的相关性

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中文摘要：目的观察H型高血压急性缺血性脑卒中患者亚甲基四氢叶酸还原酶(MTHFR)C677T的基因多态性，分析其与H型高血压急性缺血性脑卒中患者肾功能的相关性。方法选择153例H型高血压急性缺血性脑卒中患者为观察组，同期158例非H型高血压急性缺血性脑卒中患者为对照组。两组均采集外周静脉血，采用PCR扩增和微阵列技术检测MTHFR C677T基因型，测算全身免疫炎症指数(SII)，采用日立7600型全自动生化分析仪检测两组血清肌酐，据此测算肾小球滤过率(eGFR)。采用多元线性回归分析法分析MTHFR C677T基因型与H型高血压急性缺血性脑卒中患者同型半胱氨酸(Hcy)、eGFR的相关性，采用Spearman相关分析法分析SII与H型高血压急性缺血性脑卒中患者eGFR、Hcy的相关性。结果与对照组相比，观察组患者TT基因型分布频率最高，T等位基因频率最高(χ2 分别为 19。188、5。138，P均<0。05)。观察组、对照组患者SII分别为 583。54(384。97，903。73)、425。03(310。26，583。16)，二者相比，P<0。05。与CC、CT基因型比较，TT基因型的H型高血压急性缺血性脑卒中患者血清Hcy水平高，eGFR水平低(F分别为28。544、3。749，P均<0。05)。MTHFR C677T TT基因型与H型高血压急性缺血性脑卒中患者血清Hcy呈正相关(β=4。173，P<0。05)，与 eGFR呈负相关(β=-6。559，P<0。05)。SII与H型高血压急性缺血性脑卒中血清Hcy水平呈正相关(r=0。226，P<0。05)，与 eGFR呈负相关(r=-0。129，P<0。05)。结论 H型高血压急性缺血性脑卒中患者MTHFR C677T基因型主要为TT型。MTHFR C677T TT基因型的H型高血压急性缺血性脑卒中患者可能更易引起肾功能下降。

外文标题：MTHFR C677T gene polymorphism in patients with H-type hypertension combined with acute ischaemic stroke and its correlation with renal function

外文摘要：Objective To observe the gene polymorphism of methylenetetrahydrofolate reductase(MTHFR)C677T in patients with H-type hypertension combined with acute ischaemic stroke and to analyze its correlation with renal function in these patients.Methods Totally 153 patients with H-type hypertension combined with acute ischaemic stroke were se-lected as the observation group,and 158 patients with non-H-type hypertension combined with acute ischaemic stroke in the same period were selected as the control group.Peripheral venous blood was collected from both groups,and MTHFR C677T genotype was detected by PCR amplification and microarray technology to measure systemic immune inflammation index(SII),and serum creatinine levels were measured using a Hitachi 7600 automatic biochemical analyzer in order to calculate the estimated glomerular filtration rate(eGFR)in both group.Multiple linear regression analysis was employed to assess the correlations of MTHFR C677T genotypes with homocysteine(Hcy)level and eGFR in patients with H-type hy-pertension combined with acute ischaemic stroke,and Spearman correlation analysis was employed to assess the correla-tions of SII with eGFR and Hcy levels in patients with H-type hypertension combined with acute ischaemic stroke.Results Compared with the control group,patients in the observation group had the highest frequency of TT genotype dis-tribution and the highest frequency of T allele(χ2=19.188,5.138,respectively;both P<0.05).The SII of patients in the observation and control groups were 583.54(384.97,903.73)and 425.03(310.26,583.16),respectively,with statis-tically significant difference between these two groups(P<0.05).TT genotype patients with H-type hypertension com-bined with acute ischaemic stroke had higher serum Hcy level and lower eGFR level than patients with CC and CT geno-types(F=28.544,3.749,respectively;both P<0.05).The TT type of MTHFR C677T gene was positively correlated with serum Hcy level in patients with H-type hypertension combined with acute ischaemic stroke(β=4.173,P<0.05)and was negatively correlated with eGFR level(β=-6.559,P<0.05).The SII was positively correlated with serum Hcy level(r =0.226,P<0.05)and was negatively correlated with eGFR level(r=-0.129,P<0.05)in patients with H-type hyperten-sion combined with acute ischaemic stroke.Conclusions Patients with H-type hypertension combined with acute isch-aemic stroke predominantly exhibit the TT genotype of the MTHFR C677T gene.It is suggested that patients with H-type hypertension combined with acute ischaemic stroke carrying the TT genotype of MTHFR C677T may be more prone to expe-riencing a decline in renal function.

外文关键词：

methylenetetrahydrofolate reductasegene polymorphismshomocysteinesystemic immune inflamma-tory indexglomerular filtration rateH-type hypertensionacute ischaemic cerebral stroke

作者：

徐玉洁、高娟、王子文、王井辉、任涵、耿硕、刘海杰

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作者单位：

保定市第一中心医院神经内科,河北保定 071000

承德医学院研究生学院

河北医科大学研究生学院

保定市第一中心医院内分泌实验室

首都医科大学宣武医院神经内科

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关键词：

亚甲基四氢叶酸还原酶基因多态性同型半胱氨酸全身免疫炎症指数肾小球滤过率 H型高血压急性缺血性脑卒中

基金：

保定市科技局自筹立项项目

项目编号：

2241ZF052

出版年：

2024

DOI：

10.3969/j.issn.1002-266X.2024.06.006

山东医药

山东卫生报刊社

山东医药

CSTPCD

影响因子：1.225

ISSN：1002-266X

年,卷(期)：2024.64(6)

参考文献量33