CAJ | 학술논문

目的探讨血小板膜糖蛋白(glycoprotein,GP)ⅡbHPA-3基因多态性与天津地区汉族人群缺血性卒中发病风险和转归的相关性.方法连续纳入急性缺血性卒中患者和性别、年龄相匹配的健康体检者.采用聚合酶链反应-限制性片段长度多态性方法检测GPⅡbHPA-3基因多态性.转归不良定义为6个月时改良Rankin量表评分＞2分.结果共纳入224例急性缺血性卒中患者和98例性别、年龄相匹配的健康体检者.急性缺血性卒中组bb基因型(45.09％对15.06％;x2=40.618,P＜0.001)和b等位基因(63.84％对33.67％;x2 =50.064,P＜0.001)频率显著高于对照组;多变量logistic回归分析显示,bb基因型是缺血性卒中的独立危险因素(优势比5.838,95％可信区间2.653～ 12.843;P＜0.001).在各TOAST亚型中,大动脉粥样硬化型组bb基因型(x2=10.912,P=0.028)和b等位基因(x2 =11.801,P=0.019)频率显著高于其他各组.转归不良组大动脉粥样硬化性卒中的患者构成比(64.52％对29.63％;x2=29.456,P＜0.001)以及bb基因型(66.13％对37.04％;x2=17.422,P＜0.001)和b等位基因(75.00％对59.57％;x2=9.252,P=0.002)频率显著高于转归良好组;多变量logistic回归分析显示,bb基因型是缺血性卒中患者转归不良的独立危险因素(优势比3.842,95％可信区间1.782～8.283;P =0.001).结论 bb基因型可能是天津地区汉族人群缺血性卒中发病和转归不良的独立危险因素.
목적 탐토혈소판막당단백(glycoprotein,GP)ⅡbHPA-3기인다태성여천진지구한족인군결혈성졸중발병풍험화전귀적상관성.방법 련속납입급성결혈성졸중환자화성별、년령상필배적건강체검자.채용취합매련반응-한제성편단장도다태성방법검측GPⅡbHPA-3기인다태성.전귀불량정의위6개월시개량Rankin량표평분＞2분.결과 공납입224례급성결혈성졸중환자화98례성별、년령상필배적건강체검자.급성결혈성졸중조bb기인형(45.09％대15.06％;x2=40.618,P＜0.001)화b등위기인(63.84％대33.67％;x2 =50.064,P＜0.001)빈솔현저고우대조조;다변량logistic회귀분석현시,bb기인형시결혈성졸중적독립위험인소(우세비5.838,95％가신구간2.653～ 12.843;P＜0.001).재각TOAST아형중,대동맥죽양경화형조bb기인형(x2=10.912,P=0.028)화b등위기인(x2 =11.801,P=0.019)빈솔현저고우기타각조.전귀불량조대동맥죽양경화성졸중적환자구성비(64.52％대29.63％;x2=29.456,P＜0.001)이급bb기인형(66.13％대37.04％;x2=17.422,P＜0.001)화b등위기인(75.00％대59.57％;x2=9.252,P=0.002)빈솔현저고우전귀량호조;다변량logistic회귀분석현시,bb기인형시결혈성졸중환자전귀불량적독립위험인소(우세비3.842,95％가신구간1.782～8.283;P =0.001).결론 bb기인형가능시천진지구한족인군결혈성졸중발병화전귀불량적독립위험인소.
Objective To investigate the correlation between platelet membrane glycoprotein Ⅱ b HPA-3 polymorphism and the risk of ischemic stroke and outcomes in a Chinese Han population in Tianjin area.Methods Consecutive patients with acute ischemic stroke and sex-and age-matched healthy subjects were enrolled.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect glycoprotein Ⅱb HPA-3 polymorphism.Poor outcome was defined as the modified Rankin scale score ＞2 at 6 months.Results A total of 224 patients with acute ischemic stroke and 98 sex-and age-matched healthy subjects were enrolled.The bb genotype (45.09％ vs.15.06％;x2 =40.618,P ＜0.001) and b allele (63.84％ vs.33.67％;x2 =50.064,P ＜ 0.001) frequencies of the acute ischemic stroke group were significantly higher than those of the control group;multivariate logistic regression analysis showed that the bb genotype was an independent risk factor for ischemic stroke (odds ratio 5.838,95％ confidence interval 2.653-12.843;P＜0.001).In each TOAST subtypes,the bb genotype (x2 =10.912,P=0.028) and b allele (x2 =11.801,P=0.019) frequencies of the large artery atherosclerosis group were significantly higher than those of other groups.The proportions of the patients with large artery atherosclerosis (64.52％ vs.29.63％;x2 =29.456,P＜0.001) and bb genotype (66.13％ vs.37.04％;x2 =17.422,P ＜0.001),and b allele (75.00％ vs.59.57％;x2 =9.252,P =0.002) frequencies of the poor outcome group were significantly higher than those of the good outcome group;multivariate logistic regression analysis showed that the bb genotype was an independent risk factors for poor outcome in patients with ischemic stroke (odds ratio 3.842,95％ confidence interval 1.782-8.283;P =0.001).Conclusions The bb genotype may be an independent risk factor for the onset of ischemic stroke and poor outcomes in the Chinese Han population in Tianjin area.