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Received:August 10, 2018 Published Online:September 24, 2019
Received:August 10, 2018 Published Online:September 24, 2019
中文摘要: 目的探讨亚甲基四氢叶酸还原酶（MTHFR）C677T基因突变对脑梗死患者叶酸降低同型半胱氨酸(Hcy)治疗的影响。方法将2016年9月至2017年4月在许昌市中心医院神经内科就诊的脑梗死患者182例纳入本研究,所有患者均合并高同型半胱氨酸血症(HHcy)。依据MTHFR C677T基因检测结果,将患者分为观察组和对照组,观察组患者MTHFR C677T未发生基因突变,基因类型为CC型;对照组患者MTHFR C677T发生基因突变,基因类型为CT和TT型。两组患者均在脑梗死常规治疗基础上给予叶酸片降低Hcy治疗。记录患者应用叶酸治疗前、治疗后3个月、6个月血浆Hcy的变化,计算两组患者治疗6个月时,血浆Hcy的下降幅度和降低血浆Hcy治疗有效率,并分析MTHFR C677T基因突变对叶酸降低Hcy治疗的影响。结果观察组和对照组分别有56例(30.77%)和126例(69.23%)患者,观察组患者服药后3个月、6个月血浆Hcy明显低于对照组,差异有统计学意义(P<0.01);两组服用叶酸治疗后3个月,血浆Hcy较治疗前均有所降低,观察组血浆Hcy与治疗前相比较,差异有统计学意义(P<0.01);两组服用叶酸治疗后6个月,血浆Hcy较治疗前均有明显下降,观察组患者血浆Hcy的下降幅度和降低Hcy治疗有效率明显高于对照组,差异有统计学意义(P<0.05,P<0.01)。结论MTHFR C677T基因突变会降低脑梗死患者应用叶酸降低血浆Hcy的治疗效果。
中文关键词: 亚甲基四氢叶酸还原酶；C677T 基因突变 脑梗死 叶酸 同型半胱氨酸
Abstract:Objective To investigate the influences of methylene hydrofolate reductase C677T (MTHFR C677T) gene mutation on homocysteine-lowering therapy with folic acid in patients with cerebral infarction. Methods A total of 182 patients with cerebral infarction were enrolled,who were complicated with hyperhomocysteinemia (HHcy) admitting to neurology department of Xuchang Central Hospital from September 2016 to April 2017.According to the results of MTHFR C677T gene detection,the patients were divided into observation group in which no MTHFR C677T gene mutation occurred,and the genetype was CC and control group in which MTHFR C677T gene mutation occurred,and the genetypes were CT and TT.On the basis of conventional treatment of cerebral infarction,homocysteine-lowering therapy with folic acid was given in two groups.The changes of plasma Hcy concentration were recorded before and after folic acid treatment for 3 months and 6 months.The decrease of plasma Hcy level and the effective rate were calculated after 6 months of treatment.The impact of MTHFR C677T gene mutation on homocysteine-lowering therapy with folic acid was analyzed. Results There were 56 cases (30.77%) in observation group and 126 cases (69.23%) in control group,respectively.The plasma Hcy levels in observation group were significantly lower than those in control group at 3- and 6- month after taking folic acid supplements(all P<0.01).At 3 months after treatment,the plasma Hcy levels decreased compared with pre-treatment in both groups,and there was statistical difference in plasma Hcy level between pre-tretment and post-treatment in observation group(P<0.01).At 6 months after treatment,the plasma Hcy levels decreased significantly compared with pre-treatment in two groups,and the decline of plasma Hcy level and the effective rate of lowing Hcy therapy in observation group were statistically better than those in control group(P<0.05,P<0.01). Conclusion MTHFR C677T gene mutation can reduce the effect of homocysteine-lowering therapy with folic acid in patients with cerebral infarction.
keywords: Methylene hydrofolate reductase C677T Gene mutation Cerebral infarction Folic acid Homocysteine
文章编号： 中图分类号：R 743.3 文献标志码：B
基金项目:河南省医学科技攻关计划项目（201602372）
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