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目的探讨解耦联蛋白(UCP)-2基因-866G>A突变与2型糖尿病(T2DM)脑卒中复发相关性。方法 4年随访观察405例脑卒中初发的T2DM患者相关临床危险因素,比较发生终点事件(A组,183例)和未发生终点事件(B组,222例)的基因型分布。二磷酸腺苷(ADP)和(或)肾上腺素作为诱导剂测定血小板聚集率。分析基因分型与抗血小板药物的相关性。结果两组各基因型分布并无统计学差异(P>0.05)。与GG野生型患者相比,携带A等位基因的高龄肥胖男性患者增加脑卒中复发风险(P<0.05)。携带A等位基因的患者发生氯吡格雷抵抗的几率远远高于GG野生型患者(P<0.01)。结论 UCP-2基因-866G>A突变可能引发氯吡格雷抵抗,从而对T2DM脑卒中复发及预后产生影响。
Objective To investigate the relationship between the -866G> A mutation of uncoupling protein (UCP) -2 gene and the recurrence of stroke in type 2 diabetes mellitus (T2DM). Methods Four-year follow-up was performed to investigate the clinical risk factors of 405 newly diagnosed T2DM patients with stroke. The genotypes of terminal events (group A, n = 183) and non-endpoint events (group B, n = 222) were compared. Platelet aggregation rate was determined using adenosine diphosphate (ADP) and / or epinephrine as inducers. Analysis of genotyping and antiplatelet drug relevance. Results There was no significant difference in genotype distribution between the two groups (P> 0.05). Older obese men with A allele increased the risk of stroke recurrence (P <0.05) compared with GG wild-type patients. The incidence of clopidogrel resistance in patients carrying the A allele was significantly higher than in the GG wild-type patients (P <0.01). Conclusion UCP-2 gene -866G> A mutation may trigger clopidogrel resistance, and thus affect the recurrence and prognosis of stroke in T2DM.