急性脑梗死患者β纤维蛋白原-455G/A基因多态性和血浆纤维蛋白原水平研究

摘要

Objectives To investigate the relationship between the β-fibrinogen gene -455A/G polymorphism and plasma fibrinogen level and to determine the influence of the mutation on ischemic stroke. Methods Ninety-one patients (63.5±10.1 years) with ischemic stroke and 74 elderly control subjects (60.6±10.8 years) without any thromboembolic events and 98 healthy blood donators as young control (37.5±13.3 years) were enrolled in this trial. The β-fibrinogen gene -455A/G polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme Hae Ⅲ, while plasma fibrinogen levels were obtained from the prothrombin time (PT) assay. For statistical analysis, the parameters were compared between any two different groups by the unpaired Student's t test and the Chi-square test. Before analysis, log transformations for concentrations of fibrinogen were carried out.Results H2 allele frequency was higher in male ischemic stroke patients than in the elderly control (22.7% vs 7.1%, χ2=5.56, P<0.02). There was no significant difference between the female groups. In those patients without any thromboembolic events (both elderly and young control groups), the frequency of H2 decreased with age (≤40, 21.3%; 41-59, 15.4%; and ≥60, 10.2%). In the male elderly and young control groups, the level of plasma fibrinogen was lower in the H1H1 genotype (287±96?mg/dl and 234±58?mg/dl) than in H1H2 and H2H2 (331±44?mg/dl and 307±55?mg/dl; t=2.53 and 9.67, P<0.05). In the female elderly groups, this tendency was not found.Conclusion Plasma fibrinogen expression is affected by the β-fibrinogen gene -455A/G polymorphism, and the H2 allele may be a risk factor for ischemic stroke in Chinese males.%目的　初步探讨β-纤维蛋白原基因启动子区-455A/G多态性和血浆纤维蛋白原水平的关系以及在缺血性脑血管病中的意义。rn方法　91例脑梗死患者(63.5±10.1岁)、74例无血栓老年对照组 rn(60.6±10.8岁)和98例年轻对照组(健康献血员)(37.5±13.3岁)。PCR-RFLP(HaeⅢ)法分析β-纤维蛋白原基因启动子区-455A/G多态性；血浆纤维蛋白原水平测定使用PT时间法。计量资料间比较使用t检验，由于纤维蛋白原浓度呈非正态分布，故检验前作对数转化；计数资料使用卡方检验。rn结果　H2等位基因频率在男性脑梗死组明显较老年对照组高 (22.7%和7.1%，χ 2=5.56，P<0.02)，在女性组中无统计学差异；在无血栓的所有人群中(包括老年对照组和年轻对照组)，H2等位基因频率随年龄增长的分布频率是：≤40岁, 21.3%; 41-59岁, 15.4%; ≥60岁, 10.2%；男性老年和年轻对照组中，H1H1基因型人群血浆纤维蛋白原水平(287±96和234±58mg/dl)明显较H1H2-H2H2型(331±44和307±55mg/dl；t=2.53和9.67，P<0.05)低。在女性对照组中尚未发现同样现象。rn结论　男性人群血浆纤维蛋白原水平受β-纤维蛋白原基因启动子区-455A/G多态性的影响，H2等位基因可能是男性缺血性脑血管病的高危因素。