中国卒中杂志
中國卒中雜誌
중국졸중잡지
CHINESE JOURNAL OF STROKE
2015年
2期
113-119
,共7页
宋彦丽%王春娟%王蓬莲%林金嬉%马越涛%刘丽%杜万良%刘改芬
宋彥麗%王春娟%王蓬蓮%林金嬉%馬越濤%劉麗%杜萬良%劉改芬
송언려%왕춘연%왕봉련%림금희%마월도%류려%두만량%류개분
缺血性卒中%PDE4D基因%基因多态性83%联合终点事件
缺血性卒中%PDE4D基因%基因多態性83%聯閤終點事件
결혈성졸중%PDE4D기인%기인다태성83%연합종점사건
Ischemic stroke%Phosphodiesterase 4D gene%Single nucleotide polymorphism 83%Combined endpoint event
目的探索磷酸二酯酶4D(phosphodiesterase 4D,PDE4D)基因的基因多态性(single nucleotide polymorphism,SNP)83(rs966221)与缺血性卒中预后的相关性。
<br> 方法连续入组2009年10月~2011年7月北京天坛医院神经内科住院的缺血性卒中患者736例,采用Sequenom Massyarray技术检测SNP83位点基因分布情况。采用Logistic回归模型分析不同遗传模型下该位点基因多态性与卒中后3个月联合终点事件(包括卒中复发、死亡和其他血管事件等)和预后不良[改良Rankin量表(modified Rankin Scale,mRS)评分>1]的相关性,并对卒中亚型进行分层分析。
<br> 结果本研究共纳入736例患者,其中677例患者完成3个月的随访,失访率为8.02%。与未发生联合终点事件组的患者相比,发生联合终点事件组的患者年龄较大[(67.02±0.70)vs (59.98±3.35), P<0.001],既往心房颤动病史比例较高(9.3%vs 3.7%,P=0.048),入院时美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分较高[11(5~16)vs 5(2~9),P<0.001],且差异具有显著性,而两组的其他基线信息(如性别、民族、婚姻状况、居住方式、既往吸烟、饮酒、高血压、糖尿病、高脂血症和冠状动脉粥样硬化性心脏病等)差异无显著性(P>0.05)。进行基因多态性分析发现,与未发生联合终点事件患者相比,发生联合终点事件患者中SNP83 AG+GG基因型的比例较高(50.0%vs 36.7%,P=0.007),调整年龄、入院时NIHSS评分和既往心房颤动病史,Logistic回归分析显示该位点在显性模型(AG+GG vs AA)下与缺血性卒中后联合终点事件发生相关[调整后的比值比(odds ratio,OR)1.84,95%可信区间(confidence interval,CI)1.04~3.26],但并未发现该位点与卒中预后不良相关。
<br> 结论 PDE4D基因SNP83AG/GG基因型与缺血性卒中后联合终点事件发生相关。
目的探索燐痠二酯酶4D(phosphodiesterase 4D,PDE4D)基因的基因多態性(single nucleotide polymorphism,SNP)83(rs966221)與缺血性卒中預後的相關性。
<br> 方法連續入組2009年10月~2011年7月北京天罈醫院神經內科住院的缺血性卒中患者736例,採用Sequenom Massyarray技術檢測SNP83位點基因分佈情況。採用Logistic迴歸模型分析不同遺傳模型下該位點基因多態性與卒中後3箇月聯閤終點事件(包括卒中複髮、死亡和其他血管事件等)和預後不良[改良Rankin量錶(modified Rankin Scale,mRS)評分>1]的相關性,併對卒中亞型進行分層分析。
<br> 結果本研究共納入736例患者,其中677例患者完成3箇月的隨訪,失訪率為8.02%。與未髮生聯閤終點事件組的患者相比,髮生聯閤終點事件組的患者年齡較大[(67.02±0.70)vs (59.98±3.35), P<0.001],既往心房顫動病史比例較高(9.3%vs 3.7%,P=0.048),入院時美國國立衛生研究院卒中量錶(National Institutes of Health Stroke Scale,NIHSS)評分較高[11(5~16)vs 5(2~9),P<0.001],且差異具有顯著性,而兩組的其他基線信息(如性彆、民族、婚姻狀況、居住方式、既往吸煙、飲酒、高血壓、糖尿病、高脂血癥和冠狀動脈粥樣硬化性心髒病等)差異無顯著性(P>0.05)。進行基因多態性分析髮現,與未髮生聯閤終點事件患者相比,髮生聯閤終點事件患者中SNP83 AG+GG基因型的比例較高(50.0%vs 36.7%,P=0.007),調整年齡、入院時NIHSS評分和既往心房顫動病史,Logistic迴歸分析顯示該位點在顯性模型(AG+GG vs AA)下與缺血性卒中後聯閤終點事件髮生相關[調整後的比值比(odds ratio,OR)1.84,95%可信區間(confidence interval,CI)1.04~3.26],但併未髮現該位點與卒中預後不良相關。
<br> 結論 PDE4D基因SNP83AG/GG基因型與缺血性卒中後聯閤終點事件髮生相關。
목적탐색린산이지매4D(phosphodiesterase 4D,PDE4D)기인적기인다태성(single nucleotide polymorphism,SNP)83(rs966221)여결혈성졸중예후적상관성。
<br> 방법련속입조2009년10월~2011년7월북경천단의원신경내과주원적결혈성졸중환자736례,채용Sequenom Massyarray기술검측SNP83위점기인분포정황。채용Logistic회귀모형분석불동유전모형하해위점기인다태성여졸중후3개월연합종점사건(포괄졸중복발、사망화기타혈관사건등)화예후불량[개량Rankin량표(modified Rankin Scale,mRS)평분>1]적상관성,병대졸중아형진행분층분석。
<br> 결과본연구공납입736례환자,기중677례환자완성3개월적수방,실방솔위8.02%。여미발생연합종점사건조적환자상비,발생연합종점사건조적환자년령교대[(67.02±0.70)vs (59.98±3.35), P<0.001],기왕심방전동병사비례교고(9.3%vs 3.7%,P=0.048),입원시미국국립위생연구원졸중량표(National Institutes of Health Stroke Scale,NIHSS)평분교고[11(5~16)vs 5(2~9),P<0.001],차차이구유현저성,이량조적기타기선신식(여성별、민족、혼인상황、거주방식、기왕흡연、음주、고혈압、당뇨병、고지혈증화관상동맥죽양경화성심장병등)차이무현저성(P>0.05)。진행기인다태성분석발현,여미발생연합종점사건환자상비,발생연합종점사건환자중SNP83 AG+GG기인형적비례교고(50.0%vs 36.7%,P=0.007),조정년령、입원시NIHSS평분화기왕심방전동병사,Logistic회귀분석현시해위점재현성모형(AG+GG vs AA)하여결혈성졸중후연합종점사건발생상관[조정후적비치비(odds ratio,OR)1.84,95%가신구간(confidence interval,CI)1.04~3.26],단병미발현해위점여졸중예후불량상관。
<br> 결론 PDE4D기인SNP83AG/GG기인형여결혈성졸중후연합종점사건발생상관。
Objective To investigate the association between single nucleotide polymorphism 83 (SNP83) polymorphism in phosphodiesterase 4D (PDE4D) gene and prognosis of ischemic stroke.
<br> Methods We consecutively enrolled 736 ischemic stroke patients who admitted to Beijing Tiantan Hospital from October 2009 to July 2011, andSNP83 was genotyped by the Sequenom Massyarray technique. Logistic regression analysis was used to investigate the association betweenSNP83 and three months' prognosis of ischemic stroke under different genetic models. Combined endpoint event was defined as recurrence of stroke, death of all causes and other cerebro-cardiovascular events.
<br> Results A total of 736 ischemic stroke patients were enrolled into the study, and 677 patients had information of follow-up after three months of stroke. Compared with the patients without combined endpoint event, the patients with combined endpoint event were older ([67.02±0.70] vs [59.98±3.35],P<0.001), had higher proportion of history of atrial fibrillation (9.3%vs 3.7%, P=0.048), and had higher National Institutes of Health Stroke Scale (NIHSS) score[11(5~16) vs 5(2~9),P<0.001]. When analyzing the gene polymorphism, we found that the proportion of AG+GG genotype was signiifcantly higher in the patients with combined endpoint event than those without combined endpoint event (50.0%vs 36.7%,P=0.007), and in the multivariable analyzing adjusted for age, NIHSS score and history of atrial ifbrillation, theAG/GG genotype was signiifcantly associated with combined endpoint event (adjusted odds ratio [OR] 1.84, 95% conifdence interval [CI] 1.04~3.26). However, no signiifcant association was found with poor outcome after ischemic stroke.
<br> ConclusionAG/GG genotype ofSNP83 inPDE4D gene was associated with combined endpoint event after ischemic stroke.