中国临床医学
中國臨床醫學
중국림상의학
Chinese Journal of Clinical Medicine
2015年
4期
503-509
,共7页
脑源性神经生长因子%单核苷酸多态性%缺血性卒中%预后
腦源性神經生長因子%單覈苷痠多態性%缺血性卒中%預後
뇌원성신경생장인자%단핵감산다태성%결혈성졸중%예후
Brain-derived neurotrophic factor%Single nucleotide polymorphism%Ischemic stroke%Outcome
目的：：探讨中国汉族人群中脑源性神经生长因子(brain-derived neurotrophic factor,BDNF)基因的单核苷酸多态性与缺血性卒中(ischemic stroke,IS)的关系。方法：采用聚合酶链式反应-连接酶检测反应(polymerase chain reaction-ligase de-tection reaction,PCR-LDR)在494例 IS 患者(IS 组)和337例健康对照者(对照组)中检测 BDNF 基因 G196A 位点的单核苷酸多态性,计算等位基因的频率分布。IS 组在入院当天依据神经功能缺损评分(National Institutes of Health Stroke Scale,NIH-SS)评估神经功能缺损程度,脑梗死后3个月随访时根据改良 Rankin 评分标准(modified Rankin Scale,mRS)评估患者的神经功能恢复情况。结果：IS 组 BDNF 基因 G196A 位点 AA 基因型的频率高于对照组,差异有统计学意义(P <0.05)。IS 组中轻症和重症患者在 BDNF 基因 G196A 位点的基因型和等位基因频率分布上无显著差异(P =0.800)。但出院后90 d 的随访结果显示,BDNF 基因 G196A 位点 AA 基因型患者较 GG 基因型患者预后不良的相对风险度为1.406[P =0.008,比值比(OR)=0.406,95%可信区间(95%CI )：1.203~1.813]；采用 Logistic 回归方法对其他危险因素进行校正后,这种相关性仍然存在(P =0.012,OR=2.134,95%CI ：1.178~3.866)。结论：BDNF 基因 G196A 位点多态性与中国汉族人群 IS 急性期神经功能缺损程度可能无关,BDNF 基因 G196A 位点呈 GA+AA 基因型的 IS 患者预后更差,A 等位基因可能是预测中国汉族人群 IS 预后不良的独立生物学指标。
目的：：探討中國漢族人群中腦源性神經生長因子(brain-derived neurotrophic factor,BDNF)基因的單覈苷痠多態性與缺血性卒中(ischemic stroke,IS)的關繫。方法：採用聚閤酶鏈式反應-連接酶檢測反應(polymerase chain reaction-ligase de-tection reaction,PCR-LDR)在494例 IS 患者(IS 組)和337例健康對照者(對照組)中檢測 BDNF 基因 G196A 位點的單覈苷痠多態性,計算等位基因的頻率分佈。IS 組在入院噹天依據神經功能缺損評分(National Institutes of Health Stroke Scale,NIH-SS)評估神經功能缺損程度,腦梗死後3箇月隨訪時根據改良 Rankin 評分標準(modified Rankin Scale,mRS)評估患者的神經功能恢複情況。結果：IS 組 BDNF 基因 G196A 位點 AA 基因型的頻率高于對照組,差異有統計學意義(P <0.05)。IS 組中輕癥和重癥患者在 BDNF 基因 G196A 位點的基因型和等位基因頻率分佈上無顯著差異(P =0.800)。但齣院後90 d 的隨訪結果顯示,BDNF 基因 G196A 位點 AA 基因型患者較 GG 基因型患者預後不良的相對風險度為1.406[P =0.008,比值比(OR)=0.406,95%可信區間(95%CI )：1.203~1.813]；採用 Logistic 迴歸方法對其他危險因素進行校正後,這種相關性仍然存在(P =0.012,OR=2.134,95%CI ：1.178~3.866)。結論：BDNF 基因 G196A 位點多態性與中國漢族人群 IS 急性期神經功能缺損程度可能無關,BDNF 基因 G196A 位點呈 GA+AA 基因型的 IS 患者預後更差,A 等位基因可能是預測中國漢族人群 IS 預後不良的獨立生物學指標。
목적：：탐토중국한족인군중뇌원성신경생장인자(brain-derived neurotrophic factor,BDNF)기인적단핵감산다태성여결혈성졸중(ischemic stroke,IS)적관계。방법：채용취합매련식반응-련접매검측반응(polymerase chain reaction-ligase de-tection reaction,PCR-LDR)재494례 IS 환자(IS 조)화337례건강대조자(대조조)중검측 BDNF 기인 G196A 위점적단핵감산다태성,계산등위기인적빈솔분포。IS 조재입원당천의거신경공능결손평분(National Institutes of Health Stroke Scale,NIH-SS)평고신경공능결손정도,뇌경사후3개월수방시근거개량 Rankin 평분표준(modified Rankin Scale,mRS)평고환자적신경공능회복정황。결과：IS 조 BDNF 기인 G196A 위점 AA 기인형적빈솔고우대조조,차이유통계학의의(P <0.05)。IS 조중경증화중증환자재 BDNF 기인 G196A 위점적기인형화등위기인빈솔분포상무현저차이(P =0.800)。단출원후90 d 적수방결과현시,BDNF 기인 G196A 위점 AA 기인형환자교 GG 기인형환자예후불량적상대풍험도위1.406[P =0.008,비치비(OR)=0.406,95%가신구간(95%CI )：1.203~1.813]；채용 Logistic 회귀방법대기타위험인소진행교정후,저충상관성잉연존재(P =0.012,OR=2.134,95%CI ：1.178~3.866)。결론：BDNF 기인 G196A 위점다태성여중국한족인군 IS 급성기신경공능결손정도가능무관,BDNF 기인 G196A 위점정 GA+AA 기인형적 IS 환자예후경차,A 등위기인가능시예측중국한족인군 IS 예후불량적독립생물학지표。
Objective:To investigate the correlation between single nucleotide polymorphism(SNP)of BDNF gene and ischemic stroke(IS).Methods:The SNP of BDNF gene G196A in 494 patients with IS(IS group)and 337 healthy controls (control group)was detected by polymerase chain reaction-ligase detection reaction (PCR-LDR)assay,and the allele frequency was cal-culated.The degree of neural function defect in IS group was assessed at the admission day with the National Institutes of Health Stroke Severity Scale (NIHSS).On post-infarction 3-month follow-up,the neural function recovery of patients was as-sessed with the modified Rankin Scale (mRS).Results:The frequency of genotype AA at BDNF gene G196A in IS group was higher than that in control group,and the difference was statistically significant(P <0.05).There was no significant difference with regard to the genotype at BDNF gene G196A and the allele frequency between the mild patients and the severe patients (P =0.800).According to the outcomes on post-discharge 90-day follow-up,the relative risk of poor outcome in patients with genotype AA at BDNF gene G196A to that in patients with genotype GG at BDNF gene G196A was 0.046 (P =0.008,OR =0.406,95%CI :203-0.813).After the other risk factors had been adjusted with logistic regression method,the correlation was still significant(P =0.012,OR = 2.134,95%CI :1 .1 78-3.866).Conclusions:Perhaps there was no association between the polymorphism of BDNF gene G196A and the severity of neural function defect during acute phase of IS in Chinese Han popula-tion.The presence of genotype GA+AA at BDNF gene G196A was associated with much poorer outcome in patients with IS. Allele A might be the independent bioindicator of poor outcome of IS in Chinese Han population.
