Hyperhomocysteinemia and other inherited prothrombotic conditions in young adults with a history of ischemic stroke
Hyperhomocysteinemia and other inherited prothrombotic conditions in young adults with a history of ischemic stroke
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DOI：
10.1161/hs0102.100483
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发表时间：
2002-01-01
期刊：
影响因子：
8.3
通讯作者：
Di Minno, G
中科院分区：
文献类型：
--
作者：
Madonna, P;de Stefano, V;Di Minno, G
背景与目的：青年人缺血性脑卒中的发病机制尚不清楚。在过去的几年中，几项研究表明，遗传因素在这种情况下易患血栓病和中度高同型半胱氨酸血症。方法：我们对1997年1月至1999年12月间到我们中心就诊的132例连续青年缺血性脑卒中患者（66例男性，66例女性；平均+/- SD年龄，38.4 +/- 11.7岁；平均+/- SD年龄，34.8 +/- 10.9岁；范围：6个月至50岁）进行评估（首发年龄，0.05,chi(2)检验）。然而，当我们根据基因型对整个人群进行分层时，TT患者的空腹血清同型半胱氨酸水平显著高于TT对照组（25.3 +/- 36.8对15 +/- 11.6 mumol/L； P=0.02， t检验）。目前报道FV Leiden和FII G20210A基因突变与缺血性卒中倾向相关。在这种情况下，患者和对照组之间的频率无统计学差异：FV Leiden的132例中有7例（5.3%）比262例中有17例（6.5%），FII G20210A的132例中有10例（7.6%）比262例中有16例（6.1%）（P < 0.05, chi(2)检验）。结论：在目前的患者队列中，中度高同型半胱氨酸血症是唯一有助于识别缺血性卒中史的年轻人的变量。
Background and Purpose-The mechanisms of ischemic stroke in young adults are poorly understood. During the last years, several studies suggested a role for genetic factors predisposing to thrombophilia and for moderate hyperhomocysteinemia in this setting.Methods-We evaluated in 132 consecutive patients (66 males, 66 females; mean +/- SD age, 38.4 +/- 11.7 years; mean +/- SD age at first event, 34.8 +/- 10.9 years; range, 6 months to 50 years) referred to our center between January 1997 and December 1999 for a history of young adult ischemic stroke (age at first event, 0.05, chi(2) test). However, when we stratified the whole population according, to genotype, fasting serum homocysteine levels were significantly higher in TT patients than in TT controls (25.3 +/- 36.8 versus 15 +/- 11.6 mumol/L; P=0.02, t test). Mutations of FV Leiden and of FII G20210A gene are currently reported to be associated with a tendency toward ischemic stroke. Their frequencies were not statistically significantly different between patients and controls in this setting: 7 of 132 (5.3%) versus 17 of 262 (6.5%) for FV Leiden and 10 of 132 (7.6%) versus 16 of 262 (6.1%) for FII G20210A, respectively (all P>0.05, chi(2) test).Conclusions-In the present cohort of patients, moderate hyperhomocysteinemia is the only variable that helps to identify young adults with a history of ischemic stroke.