CAJ | 학술논문

目的：系统评价亚甲基四氢叶酸还原酶（ MTHFR） C677T 和 A1298C、血管紧张素原（ AGT）基因M235T、胱硫醚-β-合成酶（CBS）G919A、载脂蛋白 E（ApoE）基因多态性与≤60岁人群脑卒中的关系。方法计算机检索 Cochrane Library、PubMed 及中国知网、维普、万方数据库，收集与≤60岁人群脑卒中发生有关的基因多态性文献，检索时限均从建库至2014年1月。由2名研究者分别独立按照纳入与排除标准完成对文献的筛选、资料提取及质量评价，采用 RevMan 5.1软件进行 Meta 分析。结果本研究共纳入28项研究，包括1840例患者（病例组）和2525例对照（对照组）。Meta 分析结果显示，分别有22、17项研究报告了 MTHFR C677T 基因 CC、CT 基因型频率与≤60岁人群脑卒中的关系，结果显示病例组和对照组 CC、CT 基因型频率间差异均有统计学意义〔OR ＝0.54，95％ CI （0.39，0.78），P ＝0.0005；OR ＝1.28，95％ CI（1.07，1.54），P ＝0.007〕。4项研究报告了 MTHFR A1298C 基因多态性与≤60岁人群脑卒中的关系，结果显示两组 AA、AC 基因型频率间差异有统计学意义〔 OR ＝0.54，95％ CI （0.36，0.81），P ＝0.003；OR ＝1.68，95％ CI（1.20，2.35），P ＝0.003〕。3项研究报告了 ApoE 基因多态性与≤60岁人群脑卒中的关系，相关基因型频率间差异均无统计学意义（P ﹥0.05）。4项研究报告了 G919A 基因多态性与≤60岁人群脑卒中的关联，两组 AA、AG 和 GG 基因型频率间差异均无统计学意义（ P ﹥0.05）。结论本研究结果提示，关于 MTHFR C677T 基因多态性，CC 基因型对≤60岁人群脑卒中的发病有一定保护作用，CT 基因型是危险因素；关于MTHFR A1298C 基因多态性，AA 基因型对≤60岁人群脑卒中的发病有一定保护作用，AC 基因型是危险因素。
목적：계통평개아갑기사경협산환원매（ MTHFR） C677T 화 A1298C、혈관긴장소원（ AGT）기인M235T、광류미-β-합성매（CBS）G919A、재지단백 E（ApoE）기인다태성여≤60세인군뇌졸중적관계。방법계산궤검색 Cochrane Library、PubMed 급중국지망、유보、만방수거고，수집여≤60세인군뇌졸중발생유관적기인다태성문헌，검색시한균종건고지2014년1월。유2명연구자분별독립안조납입여배제표준완성대문헌적사선、자료제취급질량평개，채용 RevMan 5.1연건진행 Meta 분석。결과본연구공납입28항연구，포괄1840례환자（병례조）화2525례대조（대조조）。Meta 분석결과현시，분별유22、17항연구보고료 MTHFR C677T 기인 CC、CT 기인형빈솔여≤60세인군뇌졸중적관계，결과현시병례조화대조조 CC、CT 기인형빈솔간차이균유통계학의의〔OR ＝0.54，95％ CI （0.39，0.78），P ＝0.0005；OR ＝1.28，95％ CI（1.07，1.54），P ＝0.007〕。4항연구보고료 MTHFR A1298C 기인다태성여≤60세인군뇌졸중적관계，결과현시량조 AA、AC 기인형빈솔간차이유통계학의의〔 OR ＝0.54，95％ CI （0.36，0.81），P ＝0.003；OR ＝1.68，95％ CI（1.20，2.35），P ＝0.003〕。3항연구보고료 ApoE 기인다태성여≤60세인군뇌졸중적관계，상관기인형빈솔간차이균무통계학의의（P ﹥0.05）。4항연구보고료 G919A 기인다태성여≤60세인군뇌졸중적관련，량조 AA、AG 화 GG 기인형빈솔간차이균무통계학의의（ P ﹥0.05）。결론본연구결과제시，관우 MTHFR C677T 기인다태성，CC 기인형대≤60세인군뇌졸중적발병유일정보호작용，CT 기인형시위험인소；관우MTHFR A1298C 기인다태성，AA 기인형대≤60세인군뇌졸중적발병유일정보호작용，AC 기인형시위험인소。
Objective To investigate the relationship between the polymorphism of MTHFR C677T and A1298C gene, AGT M235T gene,CBS G919A gene,ApoE gene and stroke in population aged ≤60 years old. Methods We made a computer - based retrieval in Cochrane Library,PubMed,CNKI,VIP and Wanfang,in search of literatures about the relationship between gene polymorphism and stroke in population aged ≤60 years old. The search time was set from database establishment to January 2014. According to inclusion and exclusion criteria,two researchers separately conducted literature screening,data extraction and quality evaluation. RevMan 5. 1 software was employed to undertake the meta - analysis. Results A total of 28 independent researches were included,covering 1 840 patients(case group)and 2 525 controls(control group). There were 22,17 researches that reported the correlation between MTHFR C677T gene CC,CT genotype and stoke in population aged ≤60 years old respectively,and the Meta - analysis showed that case group and control group were significantly different in CC and CT genotype frequency〔OR = 0. 54,95% CI(0. 39,0. 78),P = 0. 000 5;OR = 1. 28,95% CI(1. 07, 1. 54),P = 0. 007〕. There were 4 researches that reported the correlation between MTHFR A1298C gene polymorphism and stroke in population aged ≤60 years old,and the Meta - analysis showed that case group and control group were significantly different in AA and AC genotype frequency〔OR = 0. 54,95% CI(0. 36,0. 81),P = 0. 003;OR = 1. 68,95% CI(1. 20, 2. 35),P = 0. 003〕. There were 3 researches that reported the correlation between ApoE gene polymorphism and stroke in population aged ≤60 years old,and the Meta - analysis showed no significant difference(P ﹥ 0. 05)between the two groups in relevant gene frequency. There were 4 researches that reported the correlation between the G919A gene polymorphism and stroke in population aged ≤60 years old,and there were no significant differences(P ﹥ 0. 05)between the two groups in AA,AG and GG allele frequency. Conclusion For MTHFR C677T gene polymorphism,CC gene has protective effect on the onset of stroke in population aged ≤60 years old,and CT gene is a risk factor;for MTHFR A1298C gene polymorphism,AA gene has protective effect on the onset of stroke in population aged ≤60 years old,and AC gene is a risk factor.