CAJ | 학술논문

目的评价口服避孕药(OC)暴露和血管紧张素转化酶(ACE)基因多态性及其联合作用对女性脑卒中发病风险的影响.方法在前瞻性队列研究的基础上采用病例对照研究的方法,按照年龄(±3岁)和地区为每例女性脑卒中匹配一名同医院同期住院对照和一名邻里健康对照.采用普通PCR(ACE I/D)和实时荧光定量PCR (TagMan)(A-240T)方法进行基因型检测.结果 (1)妇女患脑卒中的风险随OC累积使用时间的增加而增加(P＜0.0001);(2) I/D位点的ID/DD基因型显著增加出血型脑卒中发病风险;(3)OC和ACE基因的联合作用增加出血型脑卒中的风险;(4)多因素logistic回归分析发现,OC和ID/DD基因型是出血型脑卒中的重要危险因素.结论 OC和ACE基因遗传易感性及其联合作用可能升高出血型脑卒中的发病风险.
목적 평개구복피잉약(OC)폭로화혈관긴장소전화매(ACE)기인다태성급기연합작용대녀성뇌졸중발병풍험적영향.방법 재전첨성대렬연구적기출상채용병례대조연구적방법,안조년령(±3세)화지구위매례녀성뇌졸중필배일명동의원동기주원대조화일명린리건강대조.채용보통PCR(ACE I/D)화실시형광정량PCR (TagMan)(A-240T)방법진행기인형검측.결과 (1)부녀환뇌졸중적풍험수OC루적사용시간적증가이증가(P＜0.0001);(2) I/D위점적ID/DD기인형현저증가출혈형뇌졸중발병풍험;(3)OC화ACE기인적연합작용증가출혈형뇌졸중적풍험;(4)다인소logistic회귀분석발현,OC화ID/DD기인형시출혈형뇌졸중적중요위험인소.결론 OC화ACE기인유전역감성급기연합작용가능승고출혈형뇌졸중적발병풍험.
Objective To evaluate the associations of oral contraceptives (OC) exposure,angiotensin-converting enzyme(ACE) gene polymorphism and their joint actions with the risk of stroke in Chinese women.Methods A case-control study,based on a set cohort,was carried out.Incident cases of stroke identified between July 1 1997 and June 30 2009 were enrolled.One hospital control and healthy community control were matched on region and age ( ± 3 years).A total of 453women with stroke and 919 controls were recruited.I/D genepolymorphism was detected by polymerase chain reaction (PCR) and amplification fragment length polymorphism (AFLP),A-240T polymorphism were detected by TagMan.Results ( 1 ) The risk of stroke gradually increased with the cumulative time of OC being used in women (P＜0.0001).Compared with non-users,the risk of stroke significantly increased among those with cumulative time of using OC longer than 20 years (adjusted OR was 2.07,with 95％ CI as 1.30-3.29).(2) ID/DD genotype of I/D locus indicated significantly an increased risk of hemorrhagic stroke (adjusted OR,2.37; 95％CI,1.46-3.84).(3)Women with ID/DD genotype of I/D locus or with TA/TT genotype of A-240T locus and using OC could significantly increase the risk of hemorrhagic stroke (adjusted OR was 4.59; with 95％ CI as 2.21-9.51 and OR was 2.50; with 95％CI as 1.42-4.38).(4) Data from multivariate analyses showed that both OC and ID/DD genotypes were important risk factors for hemorrhagic stroke.Conclusion ID/DD and TA/TT genotypes of ACE gene,OC and their joint action might increase the risk of stroke,especially on hemorrhagic stroke in Chinese women.