Abstract:

Objective　To explore the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) gene polymorphism and the risk of hypertensive large artery atherosclerotic stroke (LAAS), in order to identify the genetic susceptibilities and new therapeutic targets. Methods　A prospective study was conducted on 106 hypertensive patients hospitalized for LAAS at the Department of Neurology, Yulin Xingyuan Hospital from January 2020 to January 2023, forming the case group. A control group of 160 hypertensive patients, matching in the general data, was selected from the physical examination center. The control group included 80 males and 80 females, with an age of (74.72±6.60) years old, and the case group included 53 males and 53 females, with an age of (75.07±7.13) years old. The gene polymorphism of Lp-PLA2 was examined, and its association with the risk of hypertensive LAAS was analyzed using logistic regression analysis. Independent sample t test and χ² test were used. Results　There was a statistically significant difference in the frequency of R92H site RR, RH, and HH genotype between the case group and the control group [66.04% (70/106) vs. 10.00% (16/160), 16.98% (18/106) vs. 45.00% (72/160), 16.98% (18/106) vs. 45.00% (72/160)] (χ²=91.516, P<0.001). There was a statistically significant difference in the frequency of R and H alleles between the case group and the control group [74.53% (158/212) vs. 32.50% (104/320), 25.47% (54/212) vs. 67.50% (216/320)] (χ²=90.119, P<0.001). Logistic regression analysis showed that R92H (RR) genotype was a risk factor for hypertensive LAAS (OR=38.212, 95%CI 9.959-146.616, P<0.001). Conclusion　The R92H site mutation in the Lp-PLA2 gene is an important genetic risk factor for hypertensive patients developing LAAS, playing a key role in the progression of the disease.

Key words:

Hypertension, Large artery atherosclerotic stroke, Lipoprotein-associated phospholipase A2, Gene  , polymorphism

摘要：

目的　研究脂蛋白相关磷脂酶A2（lipoprotein-associated phospholipase A2，Lp-PLA2）基因多态性与高血压大动脉粥样硬化性脑梗死（large artery atherosclerotic stroke，LAAS）发生风险的关系，以鉴定遗传易感性和新的治疗靶点。方法　本研究为前瞻性研究。选取榆林市星元医院神经内科2020年1月至2023年1月收治的以LAAS住院的106例高血压患者作为病例组，同期从体检中心选取160例与病例组一般资料相符的高血压患者作为对照组。病例组男53例，女53例，年龄（75.07±7.13）岁；对照组男80例，女80例，年龄（74.72±6.60）岁。检测Lp-PLA2基因多态性，通过logistic回归分析Lp-PLA2基因多态性与高血压LAAS的风险关联。采用独立样本t检验、χ²检验。结果　病例组R92H位点RR、RH、HH基因频率与对照组比较［66.04%（70/106）比10.00%（16/160）、16.98%（18/106）比45.00%（72/160）、16.98%（18/106）比45.00%（72/160）］，差异有统计学有意义（χ²=91.516，P<0.001）；病例组R、H等位基因频率与对照组比较［74.53%（158/212）比32.50%（104/320）、25.47%（54/212）比67.50%（216/320）］，差异有统计学有意义（χ²=90.119，P<0.001）。logistic回归分析结果显示，R92H（RR）基因为高血压LAAS发生的危险因素（OR=38.212，95%CI 9.959～146.616，P<0.001）。结论　Lp-PLA2基因的R92H位点变异是高血压患者发生LAAS的重要遗传风险因素，在疾病的发展过程中扮演了关键角色。

关键词:

高血压, 大动脉粥样硬化性脑梗死, 脂蛋白相关磷脂酶A2, 基因多态性