MTHFR基因C677T多态性与卒中后认知障碍中医证型相关性研究
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摘要
目的:探讨亚甲基四氢叶酸还原酶(MTHFR)突变基因C677T位点基因多态性与卒中后认知障碍不同中医证型的相关性。方法:运用MMSE筛选出190例卒中后伴有认知损的患者,根据相关文献研究及证候诊断积分将中医辨证分为:肾精亏虚证、痰浊阻窍证、热毒内盛证、瘀血阻络证、肝阳上亢证、腑滞浊留证、气血亏虚证7个证型,通过聚合酶链反应-限制性片段长度多态性分析法(PCR-RFLP)检测MTHFR基因C677T位点基因多态性,然后分析MTHFR基因C677T多态性与卒中后认知损害中医症候的相关性。结果:对于C677T位点,CC基因型的分布频率以气血亏虚证(8,44%)、热毒内盛证(12,46.2%)为主;CT基因型的分布频率以肝阳上亢证(9,42.9%),腑滞浊留证(18,56.3%)为主;TT基因型分布频率以肾精亏虚证(16,45.7%)、瘀血阻络证(16,57.1%)为主。C等位基因以气血亏虚证及肝阳上亢证为主,T等位基因主要以肾精亏虚证、瘀血阻络证为主;相关性分析得出:CT基因主要与痰浊阻窍证(P<0.05)、瘀血阻络证相关(P<0.05),CC基因各证型无明显差异,TT基因型主要与肾精亏虚证(P<0.05)相关。结论:MTHFR基因C677T位点基因多态性与卒中后认知损害的中医证型有显著相关。
Objective:To explore the correlation between the polymorphisms of the C677T loci of the methyl-tetrahydrofolate reductase(MTHFR)gene and the cognitive impairment after stroke. Methods:We use the MMSE to select 190 patients with post-stroke cognitive impairment. According to the research of relevant literature and symptoms in the diagnosis of integration of traditional Chinese medicine,they can be divided into:kidney essence deficiency syndrome,phlegm and turbidity obstructing orifices syndrome,hyperthermia and toxicity syndrome,blood stasis obstructing collaterals syndrome,liver Yang hyperactivity syndrome,visceral turbidity retention syndrome,Qi and blood deficiency syndrome. By polymerase chain reaction-restriction fragment length polymorphism analysis(PCR-RFLP)testing sites of MTHFR gene C677T gene polymorphism,and then analysis of MTHFR gene C677T polymorphism and the correlation of cognitive impairment TCM symptoms after stroke. Results:For the C677T site,the distribution frequency of CC genotype was mainly based on Qi and blood deficiency syndrome(8,44%)and hyperthermia and toxicity syndrome(12,46.2%). The distribution frequency of CT gene type was based on the liver Yang hyperactivity syndrome(9,42.9%),and visceral turbidity retention syndrome(18,56.3%). TT genotype distribution frequency was mainly based on kidney essence deficiency syndrome(16,45.7%)and blood stasis obstructing collaterals syndrome(16,57.1%). The Callele was mainly based on Qi and blood deficiency syndrome and liver Yang hyperactivity syndrome,and the T allele was mainly based on the kidney essence deficiency syndrome and blood stasis obstructing collaterals syndrome. Correlation analysis:the main CT gene and obsessed with the phlegm and turbidity obstructing orifices syndrome(P<0.05),blood stasis obstructing collaterals syndrome(P<0.05),there was no difference between the CC genotype each card,TT genotype was mainly associated with and kidney essence deficiency syndrome(P<0.05).Conclusion:The gene polymorphism of MTHFR gene C677T has a significant correlation with the TCM syndromes of post-stroke cognitive impairment.
Objective:To explore the correlation between the polymorphisms of the C677T loci of the methyl-tetrahydrofolate reductase(MTHFR)gene and the cognitive impairment after stroke. Methods:We use the MMSE to select 190 patients with post-stroke cognitive impairment. According to the research of relevant literature and symptoms in the diagnosis of integration of traditional Chinese medicine,they can be divided into:kidney essence deficiency syndrome,phlegm and turbidity obstructing orifices syndrome,hyperthermia and toxicity syndrome,blood stasis obstructing collaterals syndrome,liver Yang hyperactivity syndrome,visceral turbidity retention syndrome,Qi and blood deficiency syndrome. By polymerase chain reaction-restriction fragment length polymorphism analysis(PCR-RFLP)testing sites of MTHFR gene C677T gene polymorphism,and then analysis of MTHFR gene C677T polymorphism and the correlation of cognitive impairment TCM symptoms after stroke. Results:For the C677T site,the distribution frequency of CC genotype was mainly based on Qi and blood deficiency syndrome(8,44%)and hyperthermia and toxicity syndrome(12,46.2%). The distribution frequency of CT gene type was based on the liver Yang hyperactivity syndrome(9,42.9%),and visceral turbidity retention syndrome(18,56.3%). TT genotype distribution frequency was mainly based on kidney essence deficiency syndrome(16,45.7%)and blood stasis obstructing collaterals syndrome(16,57.1%). The Callele was mainly based on Qi and blood deficiency syndrome and liver Yang hyperactivity syndrome,and the T allele was mainly based on the kidney essence deficiency syndrome and blood stasis obstructing collaterals syndrome. Correlation analysis:the main CT gene and obsessed with the phlegm and turbidity obstructing orifices syndrome(P<0.05),blood stasis obstructing collaterals syndrome(P<0.05),there was no difference between the CC genotype each card,TT genotype was mainly associated with and kidney essence deficiency syndrome(P<0.05).Conclusion:The gene polymorphism of MTHFR gene C677T has a significant correlation with the TCM syndromes of post-stroke cognitive impairment.
引文
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[2]卢峰,王世聪,吴松鹰.中风后认知功能障碍中医证候特征的文献研究[J].中医研究,2016,29(1):67-69.
[3]张彦红,梁伟雄,朱磊.血管性认知障碍患者中医证候与认知障碍相关性探讨[J].中医学报,2013,28(5):725-728.
[4]刘晓婷,孙海英,田立.轻度认知障碍中医证候与认知损害特点的相关性[J].中医杂志,2016,57(14):1222-1225.
[5]赵虹,张秋娟,周洋,等.急性脑梗死后认知障碍与中医证型的相关分析[J].中国临床康复,2005(9):1-3.
[6]程蕊容,辛秀峰,刘章佩,等.卒中后认知障碍的研究进展[J].临床荟萃,2018,33(1):89-92.
[7]尹顺雄,闵连秋.高血压、高同型半胱氨酸血症与血管性认知障碍[J].中国卒中杂志,2014,9(6):516-521.
[8]韩瑞玲,陈进,吴薇,等.缺血性脑卒中患者血浆同型半胱氨酸水平和MTHFR基因多态性分析[J].神经损伤与功能重建,2017,12(6):486-489.
[9]朱阿娣,周俊山,张颖冬.脑小血管病患者认知功能障碍与血浆同型半胱氨酸的关系[J].中华全科医学,2014,12(11):1745-1747.
[10]Atticus H Hainsworth,Natalie E Yeo,Erica M Weekman,et al.Homocysteine hyperhomocysteinemia and vascular contributions to cognitive impairment and dementia(VCID)[J]. BBAMolecular Basis of Disease,2016,1862(5):1571.
[11]Perry IJ,Refsum H,Morris RW,et al. Prospective study of serum total homocysteine concent ration and risk of stroke in middleaged British men[J]. Lancet,1995,346(8987):1395-1398.
[12]施梦丽,弓园芳,陈淅泠.同型半胱氨酸浓度及MTHFR基因多态性与缺血性脑卒中的相关性[J].中国实用神经疾病杂志,2014,17(17):53-54.
[13]Schafer JH,Glass TA,Bolla KI,et al. Homocysteine and cognitivefunction in a population-based study of older adults[J].AM GeriatrSoc,2005,53(3):381-388.
[14]马洁,张云云.血管性认知障碍的研究进展[J].中西医结合心脑血管病杂志,2013,11(9):1111-1112.
[15]廖纯格,叶建新.血管性认知功能障碍相关基因的研究进展[J].医学综述,2015,21(6):964-966.
[16]马青,唐民科,孙文燕.血管性痴呆中医发病机制现代研究述要[J].中华中医药杂志,2018,33(1):212-215.