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目的探讨基质金属蛋白酶3(MMP-3)血清水平及其启动子区基因rs522616(-709A/G)多态性与低分子肝素试验病因分型(TOAST)中,大动脉粥样硬化性(LAA)和小动脉闭塞性(SAO)卒中的相关性。方法选取289例急性缺血性卒中(发病≤3d)患者,LAA卒中185例,SAO卒中104例,应用酶联免疫吸附法(ELISA)检测血清MMP-3水平,聚合酶链反应后直接测序法检测其启动子基因rs522616多态性。结果①LAA组MMP-3血清水平为(245±56)ng/ml,高于SAO组的(227±51)ng/ml,差异有统计学意义(P<0.01)。②LAA组患者中,MMP-3基因rs522616多态位点AA基因型频率为50.8%,A等位基因频率为71.1%,分别高于SAO组的38.5%和61.5%,差异有统计学意义(P<0.05)。③多因素Logistic回归分析发现,AA基因型(OR=1.72,95%CI:1.04～2.85)和MMP-3(OR=0.014,95%CI:0.00～0.29)水平增高是LAA型卒中的独立危险因子。结论与SAO性卒中比较,MMP-3血清增高水平及rs522616基因多态性位点AA基因型与LAA性卒中关系更为密切。
Objective To investigate the relationship between atherosclerosis (LAA) and serum levels of matrix metalloproteinase-3 (MMP-3) gene and its promoter region rs522616 (-709A / G) polymorphism and low molecular weight heparin test (TOAST) And small artery occlusion (SAO) stroke. Methods A total of 289 patients with acute ischemic stroke (≤3 days) were enrolled. Among them, 185 were LAA and 104 were SAO. Serum MMP-3 levels were detected by enzyme linked immunosorbent assay (ELISA) and direct sequencing by polymerase chain reaction Detect its promoter gene rs522616 polymorphism. Results ① The serum level of MMP-3 in LAA group was (245 ± 56) ng / ml, which was significantly higher than that in SAO group (227 ± 51) ng / ml (P <0.01). ② The frequency of AA genotype in rs522616 polymorphism loci in LAC patients was 50.8% and A allele was 71.1%, which was higher than that in SAO patients (38.5% and 61.5% respectively) (P <0.05). ③Multivariate Logistic regression analysis showed that the elevated AA genotype (OR = 1.72, 95% CI: 1.04-2.85) and MMP-3 (OR = 0.014, 95% CI: 0.00-0.29) were independent risk of LAA-type stroke factor. Conclusions Compared with SAO stroke, the serum level of MMP-3 and AA genotype of rs522616 polymorphism locus are more closely related to LAA stroke.