脑梗死患者Hcy及MTHFR基因多态性及颈动脉IMT关系.docVIP

脑梗死患者Hcy及MTHFR基因多态性及颈动脉IMT关系 　【摘要】; 目的; 探讨Hcy、MTHFR C677T基因多态性与颈动脉IMT及脑梗死之间的关系。; 观察42例脑梗死患者和40例对照者，用循环酶法测定Hcy水平，采用聚合酶链反应－限制片长多态性方法检测MTHFR基因多态性，用彩色多普勒检查颈动脉IMT。结果; 病例组血清Hcy 浓度显著高于对照组；Hcy是颈动脉IMT增厚及脑梗死的促进因素；MTHFR基因多态性非颈动脉IMT增厚及脑梗死的危险因素。结论; 血清Hcy升高是动脉粥样硬化及脑梗死的独立危险因素，单纯的MTHFR尚不能认为是动脉粥样硬化及脑梗死的独立危险因素。 　　【关键词】 脑梗死；同型半胱氨酸；5，10－亚甲基四氢叶酸还原酶；颈动脉IMT ; relationship between homocysteine，MTHFR gene polymorphism and carotid intima-media thickness in cerebral infarction patients ; 【Abstract】; Objective; To investigate the relationship of homocysteine(Hcy) level and genetic polymorphisms of methylenetetrahydrofolate reductase(MTHFR); related to homocysteine metabolism with carotid intima-media thickness(IMT)in cerebral infarction patients?Methods; In 42 cerebral infarction patients and 40 healthy people，serum Hcy level was measured by cyclophorase assay；MTHFR genetic C677T polymorphism was determined by polymerase chain reaction；carotid intimal-medial wall thickness was determined by the use of the duplex ultrasonography?Results; The Hcy level in the patient group was significantly higher than that in the control group (Plt;0?001)? Hcy is related to the thickness of carotid intimal-medial thikness and cerebral infarction even after controlling for other traditional risk factors，but MTHFR genetic C677T polymorphism is not?Conclusion; Serum Hcy but not MTHFR is the risk factor of artherosclerosis and cerebral infarction? ; 【Key words】; cerebral infarction； homocysteine；5，10-methylenetetrahydrofolate reductase； carotid intima-media thickness ; 近年来，高同型半胱氨酸血症(hyperhomocysteinemia，Hhcy)与血管病的关系日益引起重视。对Hhcy致脑梗死机制的主要集中在对动脉粥样硬化的上。 5，10－亚甲基四氢叶酸还原酶(Methylenetetrahydrofolate reductase， MTHFR) C677T 突变是引起Hhcy的主要遗传因素。颈动脉内膜－中膜厚度(intima－media thickness，IMT)作为反映全身动脉粥样硬化的一项早期指标已用于临床［1］。本研究目的在于探讨Hcy、MTHFR基因多态性与IMT及脑梗死之间的关系。　　1; 资料与方法 ; 1.1; 一般资料; 病例组来自2006年3月1日~10月31日北京同仁及普仁医院神经内科连续住院发病1周内的脑梗死患者，符合1995年第四届全国脑血管病学术会议制定的诊断标准，均经头颅CT 或MRI确诊，排除严重心脏疾病、急慢性肝肾功能不全、恶性肿瘤、酒精或药物滥用者及近3个月服用叶酸、VitB12、VitB6者，共42例，男31例，女