目的:调查法布里病及α-半乳糖苷酶基因( GLA基因)变异在国人青年缺血性卒中患者中的出现情况。方法本研究连续纳入2012年10月至2014年3月就诊于首都医科大学宣武医院卒中单元的年龄在18~55岁的缺血性卒中患者,收集其临床资料,并采集外周血,提取DNA,进行PCR扩增GLA基因7个外显子及相邻内含子,并进行测序,在缺血性卒中人群中进行法布里病出现率的调查。结果(1)共连续纳入符合条件的青年缺血性卒中患者269例,其中脑梗死239(88.8%)例,短暂性脑缺血发作及后循环缺血30(11.2%)例,平均年龄(44±8)岁,男女比例为4∶1(男216例,占80.3%;女53例,占19.7%),TOAST分型以大动脉粥样硬化为主,占55.4%;(2)在所检269例青年缺血性卒中患者中,未检出一例明确法布里病致病突变。有12例患者出现c.-12G>A点突变,20例患者c.-10C>T点突变,这两个位点均位于外显子1的5′端非翻译区,该2个功能多态位点在不同TOAST分型中分布差异有统计学意义。结论法布里病在国人青年缺血性卒中患者中的出现率并不高,c.-10C>T位点突变在国人不同TOAST卒中亚型中存在差异,其意义还有待于进一步研究。
Objective To investigate the prevalence of Fabry disease and GLA gene mutations in young patients with ischemic stroke.Methods A total of 269 consecutive hospitalized patients of ischemic stroke,aged between 18-55 years,were recruited.DNA was extracted from peripheral blood.And 7 exons and flanking introns of α-galactosidase gene ( GLA ) were sequenced.Results The cases were cerebral infarction (n=239,88.8%) transient ischemic attack and posterior circulation ischemia (n=30,11.2%). There were 216 males and 53 females with a mean age of 44 ±8years.Large artery atherosclerosis was predominant at 55.4%according to the TOAST classifications.Among them,there were c.-12G〉A point mutation (n=12) and c.-10C〉T mutation (n=20).These two sites were located in the 5 ′end of non-untranslated region in exon 1.Both loci were polymorphic loci.No disease-causing mutations were detected.Conclusion The prevalence of Fabry disease in young stroke patients is not high as in Western countries;there has some difference in TOAST types between patients with c.-10C〉T mutation and without, further studies are needed to testing the significance.