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目的:外伤性脑梗死(posttraumatic cerebral infarction,PTCI)是颅脑损伤的常见并发症之一,P2Y12受体介导血小板聚集是血栓形成的重要通路,与血小板聚集形成密切相关。本研究探讨外伤性脑梗死发生发展与血小板膜P2Y12受体基因T744C基因多态性的关系。方法:用聚合酶链反应(PCR)和限制性酶切片段长度多态性(RFLP)技术对186例外伤性脑梗死患者P2Y12受体基因T744C多态性进行分析。分别在治疗前和治疗后对所有颅脑外伤患者的伤情GCS评分,并按基因型分组对照分析结果。结果:血小板膜T744C血小板膜T744C基因型基因频率分别为TT基因型59.14%、TC型32.26%、CC型8.60%,T等位基因75.27%、C等位基因24.73%;其中TT基因型对奥扎格雷反应较敏感,GCS评分预后好;而CC型对奥扎格雷反应性低,预后差。结论:T744C基因多态性中CC基因型可能导致外伤性脑梗死临床及预后存在明显的个体差异,与其对抗血小板药物抵抗有关。T744C的C等位基因可能是脑梗死的遗传危险因素,开展相关遗传学风险研究,对于进一步缓解脑梗症状、改善预后具有重要意义。
PURPOSE: Traumatic cerebral infarction (PTCI) is one of the common complications of craniocerebral injury. P2Y12 receptor-mediated platelet aggregation is an important pathway of thrombosis, which is closely related to platelet aggregation. This study was to investigate the relationship between the occurrence and development of traumatic cerebral infarction and the polymorphism of platelet membrane P2Y12 receptor gene T744C. Methods: Polymorphisms of P2Y12 receptor gene T744C in 186 patients with traumatic cerebral infarction were analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The GCS scores of all traumatic brain injury patients before and after treatment were compared and analyzed by genotyping. Results: The T744C genotypes of platelet membrane T744C were 59.14%, 32.26%, 32.66%, 75.27% and 24.73%, respectively. The genotypes of TT genotype were Zagre’s response is more sensitive, GCS score good prognosis; and CC type of ozagrel reactivity is low, the prognosis is poor. Conclusion: The CC genotype of T744C gene polymorphism may lead to significant individual differences in the clinical and prognosis of traumatic cerebral infarction, which may be related to its resistance to antiplatelet drugs. The C allele of T744C may be the genetic risk factor of cerebral infarction. It is of great significance to carry out the study of related genetic risk to further alleviate the symptoms of cerebral infarction and improve the prognosis.