目的:研究缺血性脑卒中患者基质金属蛋白酶2(MMP2)基因多态性与病情复发及炎症介质、氧化应激分子的相关性.方法:选择2015年1月~2016年12月在陕西省人民医院就诊的初发缺血性卒中患者和复发患者,分别作为研究的初发组和复发组;选择同期体检的健康志愿者作为对照组.检测血清中MMP2基因的多态性及炎症介质的含量,外周血中氧化应激分子的表达量.结果:复发组患者血清中MMP2基因735位点CC基因型的构成比显著高于对照组及初发组(P<0.05),CT基因型和TT基因型的构成比显著低于对照组及初发组(P<0.05);MMP2基因CC基因型脑卒中患者血清HMBG1、FKN、肿瘤坏死因子(TNF)-α、白介素(IL)-1β、IL-17含量以及外周血中Keap1的mRNA表达量显著高于MMP2基因CT基因型脑卒中患者及MMP2基因TT基因型脑卒中患者(P<0.05),外周血中Nrf2、ARE、NQO1、HO1的mRNA表达量显著低于MMP2基因CT基因型脑卒中患者及MMP2基因TT基因型脑卒中患者(P<0.05).结论:缺血性脑卒中患者MMP-2基因CC基因型的出现能够加重炎症反应和氧化应激反应,与病情复发密切相关.%Objective:To study the correlation of MMP-2 gene polymorphism with disease relapse as well as inflammatory mediators and oxidative stress molecules in patients with ischemic stroke.Methods:Patients with primary and recurrent ischemic stroke who were treated in Shaanxi Provincial People's Hospital between January 2015 and December 2016 were selected as the primary group and recurrent group respectively;healthy volunteers who received physical examination during the same period were selected as control group.Serum MMP-2 gene polymorphism and inflammatory mediator levels as well as peripheral blood oxidative stress molecule expression were determined.Results:Serum MMP2 gene 735 loci CC genotype constituent ratio of recurrent group was significantly higher than that of control group and primary group while CT genotype and TT genotype constituent ratio were significantly lower than those of control group and primary group;serum HMBG1,FKN,TNF-α,IL-1β and IL-17 levels as well as peripheral blood Keap1 mRNA expression in stroke patients with MMP2 gene CC genotype were significantly higher than those in stroke patients with MMP2 gene CT genotype and MMP2 gene TT genotype while peripheral blood Nrf2,ARE,NQO1 and HO1 mRNA expression were significantly lower than those in stroke patients with MMP2 gene CT genotype and MMP2 gene TT genotype.Conclusion:MMP-2 gene CC genotype in patients with ischemic stroke can aggravate inflammatory response and oxidative stress response,and is closely related to disease relapse.
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