CAJ | 학술논문

目的探讨内皮一氧化氮合酶基因T-786C多态对吸烟的动脉瘤性蛛网膜下腔出血患者脑循环的影响. 方法收集自2006年至2008年广州军区武汉总院神经外科住院的动脉瘤性蛛网膜下腔出血汉族患者394例,根据每年吸烟量≥200支和0支将其分为吸烟组(198例)和不吸烟组(196例).彩色多普勒(TCCD)检测以上患者脑血流速度,等位基因特异性聚合酶链反应测定T-786C多态性,并通过患者尿液中F2-异前列烷排泄物来评估吸烟者的氧化应激程度. 结果 TCCD频谱提示,吸烟组中一部分患者大脑中动脉(MCA)和颈内动脉(ICA)的平均血流速度(Vm)较正常值呈明显增高趋势,而不吸烟组中MCA和ICA的Vm与正常值无明显差别.吸烟组患者不同基因型中MCA Vm、ICA Vm差异有统计学意义(P＜0.05),其中CC基因型MCA Vm[(160.9±58.5)cm/s]明显高于TT[(95.8±56.3)cm/s]、TC[(94.1±51.3)cm/s]基因型,差异有统计学意义(P＜0.05).不吸烟组患者不同基因型中MAC Vm、ICA Vm差异无统计学意义(P＞0.05).吸烟组患者尿F2-异前列烷水平明显高于不吸烟组患者,差异有统计学意义(P＜0.05). 结论内皮一氧化氮合酶基因型可改变吸烟的动脉瘤性蛛网膜下腔出血患者脑血液循环,使其脑血流速度增高.
목적 탐토내피일양화담합매기인T-786C다태대흡연적동맥류성주망막하강출혈환자뇌순배적영향. 방법 수집자2006년지2008년엄주군구무한총원신경외과주원적동맥류성주망막하강출혈한족환자394례,근거매년흡연량≥200지화0지장기분위흡연조(198례)화불흡연조(196례).채색다보륵(TCCD)검측이상환자뇌혈류속도,등위기인특이성취합매련반응측정T-786C다태성,병통과환자뇨액중F2-이전렬완배설물래평고흡연자적양화응격정도. 결과 TCCD빈보제시,흡연조중일부분환자대뇌중동맥(MCA)화경내동맥(ICA)적평균혈류속도(Vm)교정상치정명현증고추세,이불흡연조중MCA화ICA적Vm여정상치무명현차별.흡연조환자불동기인형중MCA Vm、ICA Vm차이유통계학의의(P＜0.05),기중CC기인형MCA Vm[(160.9±58.5)cm/s]명현고우TT[(95.8±56.3)cm/s]、TC[(94.1±51.3)cm/s]기인형,차이유통계학의의(P＜0.05).불흡연조환자불동기인형중MAC Vm、ICA Vm차이무통계학의의(P＞0.05).흡연조환자뇨F2-이전렬완수평명현고우불흡연조환자,차이유통계학의의(P＜0.05). 결론 내피일양화담합매기인형가개변흡연적동맥류성주망막하강출혈환자뇌혈액순배,사기뇌혈류속도증고.
Objective To study the effect ofT-786C polymorphism of endothelial NO synthase gene on cerebral circulation in smokers with aneurysmal subarachnoid hemorrhage. Methods Three hundred and ninety-four patients with aneurysmal subarachnoid hemorrhage were adopted in our study;smokers and nonsmokers were defined by 200 and 0, respectively, according to the smoking index (quantity of cigarettes per year). Transcranial color-coded Doppler (TCCD) was employed to detect the alterations of flow velocity of cerebral arteries. Genotyping ofT-786C was performed by using a newly developed allele-specific polymerase chain reaction. Degree of oxidative stress of these patients were evaluated by measuring the level of F2-isoprostane excretion in the urine. Results The mean flow velocity (Vm) of middle cerebral artery (MCA) and internal carotid artery (ICA) was obviously increased as compared with that of the other normal ones in most of the smokers. The Vm of MCA and ICA in nonsmokers was not obviously different as compared with the normal values. The 3 genotypes ofT-786C in smokers showed significant difference in Vm of MCA and ICA (P＜0.05); the Vm of CC genotype ([60.73±63.58] cm/s) was obviously increased as compared with that of TT ([95.8±53.5] cm/s) and TC ([93.6±51.6] cm/s) genotypes (P＜0.05). The 3 genotypes ofT-786C in nonsmokers did not show significant difference in Vm of MCA and ICA (P＞0.05). The level of F2-isoprostane excretion in smokers was significantly higher than that in nonsmokers (P＜0.05). Conclusion The T-786C polymorphism of endothelial NO synthase gene can increase cerebrovascular Vm by enhancing the cerebrovascular circulation of smokers with aneurysmal subarachnoid hemorrhage.